Individual
MS. KIMBERLY KAY FELDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3181 SW SAM JACKSON PARK RD. L457, OREGON HEALTH SCIENCE UNIVERSITY, PORTLAND, OR 97239
(503) 494-9444
(503) 494-4264
Mailing address
3181 SW SAM JACKSON PARK RD. L457, OREGON HEALTH SCIENCE UNIVERSITY, PORTLAND, OR 97239
(503) 494-9444
(503) 494-4264
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
ORPA00804
OR
363A00000X
Physician Assistant
PA00804
OR
363AM0700X
Medical Physician Assistant
Primary
PA00804
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104711
—
OR
01
—
ORPA00804
OREGON BOARD OF MEDICAL EXAMINERS
OR
Enumeration date
06/17/2006
Last updated
12/22/2020
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