Kimberly Anne Fuller, LMT

NPI #1528198306 in Gresham, Oregon

Provider Information

NPI Number: 1528198306
Entity Type: Individual
Name: Kimberly Anne Fuller, LMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: LMT
Enumeration Date: Mar 7, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 1217 NE BURNSIDE RD STE 502
City: Gresham
State: Oregon
ZIP Code: 97030-5770
Phone: (503) 492-3910

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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