Individual
STEPHEN ROBERT KIMBROUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPHT
Contact information
Practice address
6025 JEAN RD, LAKE OSWEGO, OR 97035-5307
(503) 303-7373
Mailing address
6025 JEAN RD, LAKE OSWEGO, OR 97035-5307
(503) 303-7373
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
CPT-0009301
OR
Other
Enumeration date
08/03/2017
Last updated
08/03/2017
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