Individual
KIMBERLY WISOTZKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5440 SW WESTGATE DR, STE 175, PORTLAND, OR 97221-2420
(971) 231-5519
Mailing address
5440 SW WESTGATE DR, STE 175, PORTLAND, OR 97221-2420
(971) 231-5519
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
Other
Enumeration date
11/07/2013
Last updated
03/12/2015
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