MRS. Kimberly Tai Wise, DEM

NPI #1134411788 in Lebanon, Oregon

Provider Information

NPI Number
1134411788
Entity Type
Individual
Name
MRS. Kimberly Tai Wise, DEM
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Midwife
Credential
DEM
Enumeration Date
May 13, 2011
Last Updated
May 13, 2011

Practice Location

Address
966 CLEVELAND ST
State
Oregon
ZIP Code
97355-4422
Phone
(541) 401-1667

Specialties & Taxonomy Codes

Specialty
Midwife

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