Individual
KIMBER DONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7318 N LEAVITT AVE, PORTLAND, OR 97203-4840
(503) 567-5880
Mailing address
7318 N LEAVITT AVE, PORTLAND, OR 97203-4840
(503) 567-5880
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
29094
OR
Other
Enumeration date
07/14/2025
Last updated
07/14/2025
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