Individual
SONYA M KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
7505 SW CRESTVIEW ST, TIGARD, OR 97223-8206
(503) 936-3114
Mailing address
7505 SW CRESTVIEW ST, TIGARD, OR 97223-8206
(503) 936-3114
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10561
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10561
LMT
OR
Enumeration date
04/16/2009
Last updated
04/30/2012
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