Provider Demographics
NPI:1326282658
Name:EHLER, KIM (KIM EHLER, LMT)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:EHLER
Suffix:
Gender:F
Credentials:KIM EHLER, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21185 NW WEST UNION RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124
Mailing Address - Country:US
Mailing Address - Phone:503-997-5675
Mailing Address - Fax:
Practice Address - Street 1:3375 NW 147TH PL
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-0907
Practice Address - Country:US
Practice Address - Phone:503-997-5675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR7668173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist