Individual
KIMBERLY ANN MCKEARNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
707 SW GAINES ST, PORTLAND, OR 97239-2901
(800) 452-3563
Mailing address
707 SW GAINES ST, PORTLAND, OR 97239-2901
(503) 494-5832
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
986895
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
233496
—
OR
Enumeration date
08/01/2006
Last updated
07/14/2007
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