Individual
KIM K ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD, MD
Contact information
Practice address
511 10TH AVE SUITE 808, PORTLAND, OR 97205-4661
(503) 289-9621
(503) 289-2930
Mailing address
511 SW 10TH AVE SUITE 808, PORTLAND, OR 97205
(503) 289-9621
(503) 289-2930
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D6905
OR
Other
Enumeration date
01/21/2006
Last updated
12/11/2019
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