Individual
MISS KATELYN MAY FREEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4515 SW CORBETT AVE, PORTLAND, OR 97239-4289
(503) 327-1562
Mailing address
415 SE 29TH AVE, PORTLAND, OR 97214-1815
(503) 327-1562
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
13189
OR
Other
Enumeration date
06/22/2007
Last updated
07/08/2007
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