Individual
MS. KIMBERLY ANNE BRANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
10362 SW MCDONALD ST, TIGARD, OR 97224-4863
(503) 624-0312
(503) 639-3973
Mailing address
10362 SW MCDONALD ST, TIGARD, OR 97224-4863
(503) 624-0312
(503) 639-3973
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200150075NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200150075NP
LIC #
OR
05
—
292159
—
OR
Enumeration date
08/15/2006
Last updated
03/07/2023
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