Individual
JASON KIHLSTADIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2300 FERRY ST SW STE 6, ALBANY, OR 97322-3996
(503) 836-8380
Mailing address
2300 FERRY ST SW STE 6, ALBANY, OR 97322-3996
(503) 836-8380
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
247263
OR
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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