Individual
MR. KEVIN NORMAN PROBST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
3550 N. INTERSTATE AVE., PORTLAND, OR 97227-1097
(503) 331-6493
(503) 249-5528
Mailing address
5820 BIRD SONG WAY, GLADSTONE, OR 97027-1581
(503) 341-4039
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
000038096N3
OR
363LA2200X
Adult Health Nurse Practitioner
AP30005823
WA
Other
Enumeration date
08/17/2006
Last updated
07/08/2007
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