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Individual

KATHLEEN PETERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3098
(503) 494-7246
(503) 494-8368
Mailing address
3181 SW SAM JACKSON PARK RD, MAIL CODE SJH-2, PORTLAND, OR 97239
(503) 494-7246
(503) 494-8368

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
10009598
OR
367500000X
Certified Registered Nurse Anesthetist
Primary
10009598
OR

Other

Enumeration date
07/17/2023
Last updated
11/07/2023
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