Individual
MARTIN MBUTHIA KIMITA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14512 SE FOSTER RD, PORTLAND, OR 97236-4324
(781) 534-1079
Mailing address
15216 SE BEVINGTON AVE, MILWAUKIE, OR 97267-3354
(781) 534-1079
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/09/2024
Last updated
10/09/2024
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