Individual
KYMBERLEE SPROULE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4560 SE INTERNATIONAL WAY, SUITE 101, MILWAUKIE, OR 97222-4628
(971) 206-5202
Mailing address
350 NE 60TH AVE, E7, PORTLAND, OR 97213-3766
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
244463
OR
Other
Enumeration date
12/18/2013
Last updated
12/18/2013
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