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Individual

MRS. KIMBERLY ELAINE HALE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.M.T.

Contact information

Practice address
1920 N KILLINGSWORTH ST, PORTLAND, OR 97217-4437
(971) 279-2757
Mailing address
4715 NE 110TH AVE, PORTLAND, OR 97220-2539
(503) 929-2234

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12859
OR

Other

Enumeration date
11/06/2012
Last updated
11/06/2012
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