Individual
KIMBERLIE ANNE DAME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP
Contact information
Practice address
9135 SW BARNES RD STE 261, PORTLAND, OR 97225-6784
(503) 216-6300
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
10008811
OR
363LG0600X
Gerontology Nurse Practitioner
Primary
10008811
OR
Other
Enumeration date
05/23/2023
Last updated
11/02/2023
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