Individual
KIMBERLY GAIL ERNEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1321 NE 99TH AVE STE 100, PORTLAND, OR 97220-9437
(503) 215-9900
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA201320
OR
363AS0400X
Surgical Physician Assistant
PA22834
CA
Other
Enumeration date
03/19/2013
Last updated
07/22/2021
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