Individual
MRS. KELLY ERIN HIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
2410 SE 121ST AVE STE 216, PORTLAND, OR 97216-4085
(503) 975-8381
Mailing address
16099 SE VENICE RIDGE WAY, DAMASCUS, OR 97089
(503) 975-8381
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/21/2007
Last updated
07/08/2007
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