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Individual

MRS. KIMBERLY E KINTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
600 NE 8TH ST, #300, GRESHAM, OR 97030-7317
(503) 988-5155
(503) 988-5155
Mailing address
421 SW OAK ST, STE. 210, PORTLAND, OR 97204-1817
(503) 988-7468

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
087000274N3ANP-PP
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
096511
OR
05
22959
OR
05
275452
OR
Enumeration date
08/17/2006
Last updated
08/17/2015
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