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Individual

MRS. KIMBERLY NICOLE PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A.

Contact information

Practice address
1500 NE IRVING ST, SUITE 250, PORTLAND, OR 97232-2243
(503) 233-4356
Mailing address
5105 NE 48TH AVE, PORTLAND, OR 97218-2053
(503) 307-4004

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
03/07/2007
Last updated
07/08/2007
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