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Individual

MISS KRISTIN JOY KENNEDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
155 LIBERTY ST. NE SUITE 360, SALEM, OR 97301
(503) 269-0683
Mailing address
155 LIBERTY ST. NE SUITE 360, SALEM, OR 97301

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
15526
OR

Other

Enumeration date
10/04/2011
Last updated
10/04/2011
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