Individual
KIMBERLY SUE WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
18040 SW LOWER BOONES FERRY RD, SUITE 100, TIGARD, OR 97224-7258
(503) 216-0700
(503) 216-0750
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
NP19924
CA
208000000X
Pediatrics Physician
NP19924
CA
363L00000X
Nurse Practitioner
NP19924
CA
363LF0000X
Family Nurse Practitioner
Primary
201393029NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500667975
—
OR
01
—
NP19924
CA. BOARD OF NURSING
CA
01
—
P01404411
RR MEDICARE - PH&S
OR
Enumeration date
09/07/2010
Last updated
03/25/2021
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