Individual
POLLY KIT MALBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-4500
Mailing address
32149 SE STEVENS RD, CORBETT, OR 97019-8679
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
000033356N5
OR
367A00000X
Advanced Practice Midwife
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146159
—
OR
Enumeration date
09/20/2006
Last updated
07/08/2007
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