Individual
KIMBERLY EDMONDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1401 N 10TH AVE STE 100, STAYTON, OR 97383-1486
(503) 769-6386
(503) 769-5647
Mailing address
4777 WHITMAN CIR NE, SALEM, OR 97305-3600
(530) 680-1003
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA218013
OR
Other
Enumeration date
09/14/2022
Last updated
01/26/2024
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