Individual
KIMBERLY DAWN TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
13814 SW 110TH AVE, TIGARD, OR 97223-3882
(503) 933-2875
Mailing address
13814 SW 110TH AVE, TIGARD, OR 97223-3882
(503) 933-2875
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18787
OR
Other
Enumeration date
02/02/2012
Last updated
02/02/2012
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