Provider Demographics
NPI:1568584993
Name:DE ALTO, KIMBERLY (DC)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:
Last Name:DE ALTO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14355 SW ALLEN BLVD.
Mailing Address - Street 2:SUITE 150
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-4741
Mailing Address - Country:US
Mailing Address - Phone:503-806-5700
Mailing Address - Fax:877-940-4288
Practice Address - Street 1:14355 SW ALLEN BLVD.
Practice Address - Street 2:SUITE 150
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-4741
Practice Address - Country:US
Practice Address - Phone:503-806-5700
Practice Address - Fax:877-940-4288
Is Sole Proprietor?:No
Enumeration Date:2007-04-05
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3590111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation