Individual
MS. KIMBERLY R HYAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, MSW
Contact information
Practice address
9700 SW BEAVERTON HILLSDALE HWY, BEAVERTON, OR 97005-3306
(503) 626-9494
Mailing address
PO BOX 82819, PORTLAND, OR 97282-0819
(503) 233-5404
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164936
—
OR
01
—
R0000WDBCH
MEDICARE GROUP
OR
Enumeration date
02/22/2007
Last updated
08/02/2010
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