Individual
DR. KIMBERLY A WOLLMUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9555 SW BARNES RD STE 301, PORTLAND, OR 97225-6670
(503) 297-3371
(503) 297-7975
Mailing address
9555 SW BARNES RD STE 301, PORTLAND, OR 97225-6670
(503) 297-3371
(503) 297-7975
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD26983
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
28532
—
OR
Enumeration date
11/15/2006
Last updated
05/28/2021
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