Individual
KIMBERLY MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4890 32ND AVE SE, SALEM, OR 97317-9350
(503) 588-5647
(503) 779-1992
Mailing address
1346 ORCHARDVIEW AVE NW, SALEM, OR 97304-1955
(503) 588-5647
(503) 779-1992
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/12/2013
Last updated
11/12/2013
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