Individual
KATHLEEN KIRGIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2133 NE BROADWAY ST, PORTLAND, OR 97232-1878
(503) 804-8964
Mailing address
1610 NE TILLAMOOK ST, PORTLAND, OR 97212-4464
(503) 804-8964
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5841
OR
Other
Enumeration date
03/03/2020
Last updated
03/03/2020
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