Individual
KIMBERLY ANN PETROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12350 SW 5TH ST STE 100, BEAVERTON, OR 97005-2819
(503) 627-9194
Mailing address
12350 SW 5TH ST STE 100, BEAVERTON, OR 97005-2819
(503) 627-9194
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OR
Other
Enumeration date
02/03/2012
Last updated
02/03/2012
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