Individual
KEVIN NATHANIEL HARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1015 NW 22ND AVE, PORTLAND, OR 97210-3025
(503) 413-7711
(503) 413-6892
Mailing address
200 MULLINS DR, LEBANON, OR 97355-3983
(541) 259-0235
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/29/2022
Last updated
03/27/2025
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