Individual
KIMBERLY NICOLE SKILLICORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
3550 N INTERSTATE AVE, PORTLAND, OR 97227-1196
(503) 331-6357
Mailing address
2309 5TH AVE APT 404, SAN DIEGO, CA 92101-1673
(831) 247-2150
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2973
OR
Other
Enumeration date
07/24/2018
Last updated
12/17/2021
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