Individual
KIMBERLY ANNE LIEPOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2850 SE POWELL VALLEY RD, GRESHAM, OR 97080-1494
(503) 666-5050
Mailing address
1668 SE 35TH TER, GRESHAM, OR 97080-5123
(503) 267-7712
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F12210813
OR
Other
Enumeration date
12/28/2021
Last updated
12/28/2021
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