Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | MD192571 | OR |
NPI | 1104289768 |
---|---|
Provider Name | Dr. Kimberly Elizabeth Chesteen |
First Address | Clackamas, OR 97015-8970 |
Second Address | Clackamas, OR 97015-8970 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2016 |
Last Update Date | 04/02/2022 |