Provider Demographics
NPI:1073803235
Name:BOYER, KIMBERLY MERSCH (MD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:MERSCH
Last Name:BOYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19260 SW 65TH AVE STE 340
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-5710
Mailing Address - Country:US
Mailing Address - Phone:503-691-9777
Mailing Address - Fax:
Practice Address - Street 1:19260 SW 65TH AVE STE 340
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-5710
Practice Address - Country:US
Practice Address - Phone:971-272-4650
Practice Address - Fax:503-692-6736
Is Sole Proprietor?:No
Enumeration Date:2011-04-08
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD167155208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics