Individual
MS. KIMBERLI KEVIN DAVENPORT-HOLLADAY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MS CCCA
Contact information
Practice address
2860 SE HOLGATE BLVD, PORTLAND, OR 97202-3658
(503) 234-7843
(503) 235-6973
Mailing address
5620 SE LAMBERT ST, PORTLAND, OR 97206
(503) 475-1266
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
22613
OR
Other
Enumeration date
12/05/2005
Last updated
07/08/2007
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