Individual
KIMBERLY MARIE MINOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRM
Contact information
Practice address
10564 SE WASHINGTON ST, PORTLAND, OR 97216-2809
(503) 228-9229
Mailing address
3910 SE STARK ST, PORTLAND, OR 97214-3241
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
18-CRM-027
OR
Other
Enumeration date
03/15/2018
Last updated
03/15/2018
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