MRS. Kimberly L Waller, PA-C

NPI #1093782914 in Grants Pass, Oregon

Provider Information

NPI Number: 1093782914
Entity Type: Individual
Name: MRS. Kimberly L Waller, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Mar 1, 2006
Last Updated: Oct 28, 2019

Practice Location

Address: 1701 NW HAWTHORNE AVE
City: Grants Pass
State: Oregon
ZIP Code: 97526-1051
Phone: (541) 471-3455

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant - Medical — Medical	363AM0700X
Physician Assistant	363A00000X	Primary

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