Individual
KIMBERLY GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
66 CLUB RD, EUGENE, OR 97401-2420
(541) 393-5983
Mailing address
1655 NW HIGHLAND DR, CORVALLIS, OR 97330-2019
(530) 366-0673
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/31/2021
Last updated
08/31/2021
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