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Individual

KIMBERLY A MATKEVICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
1775 NE 39TH AVE, PORTLAND, OR 97212-5322
(503) 288-6181
Mailing address
3534 NE ALAMEDA ST, PORTLAND, OR 97212-1806

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3182ATI
OR

Other

Enumeration date
08/02/2006
Last updated
07/08/2007
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