Individual
KARA M WIDERGREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
200 NE 20TH AVE STE 10, PORTLAND, OR 97232-3094
(503) 849-2127
(971) 275-1929
Mailing address
2626 SE 59TH AVE, PORTLAND, OR 97206-1448
(509) 438-8380
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
E-10261346
OR
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
10/17/2025
Last updated
05/10/2026
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