Individual
KIMBERLY STARR WALDREP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNPC
Contact information
Practice address
1804 SE SPOKANE ST, PORTLAND, OR 97202-6742
(503) 997-9152
Mailing address
728 MOLALLA AVE, OREGON CITY, OR 97045-2799
(503) 656-9030
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201500630NP-PP
OR
Other
Enumeration date
02/06/2013
Last updated
03/15/2024
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