Individual
KIMBERLY L PENTECOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1630 SW MORRISON ST STE 100, PORTLAND, OR 97205-1916
(503) 227-7774
(503) 227-7548
Mailing address
1630 SW MORRISON ST STE 100, PORTLAND, OR 97205-1916
(503) 227-7774
(503) 227-7548
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
62787
OR
Other
Enumeration date
11/08/2018
Last updated
11/08/2018
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