Individual
KINDA LILLEY-KARKOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
2222 E POWELL BLVD, GRESHAM, OR 97080-1365
(503) 669-4300
(503) 669-4301
Mailing address
18693 SW BLANTON ST, ALOHA, OR 97078-1285
(207) 491-8763
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/20/2019
Last updated
08/26/2019
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