Individual
ILA AIRY-SUNNY KIPILMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRM
Contact information
Practice address
1312 SW WASHINGTON ST, PORTLAND, OR 97205-2327
(503) 535-1186
Mailing address
4311 SE 79TH AVE, PORTLAND, OR 97206-3308
(503) 702-6467
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/16/2021
Last updated
04/16/2021
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