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Organization

KRISTEN KAMPSTRA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTEN N KAMPSTRA (LMT)
(541) 497-0564
Entity
Organization

Contact information

Practice address
2835 SW DESCHUTES DR, REDMOND, OR 97756-7093
(541) 497-0564
Mailing address
2835 SW DESCHUTES DR, REDMOND, OR 97756-7093

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
20543
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
225700000X
OR
Enumeration date
09/26/2016
Last updated
09/26/2016
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