Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | MD25588 | OR |
N | 207X00000X | Orthopaedic Surgeon | MD25588 | OR |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | MD25588 | OR |
NPI | 1487737003 |
---|---|
Provider Name | Kimberly Leigh Workman |
First Address | Portland, OR 97225-5933 |
Second Address | Portland, OR 97225-5933 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 07/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
273850 | (05) | OR |
MD25588 | OREGON MEDICAL LICENSE (01) | OR |