Provider Demographics
NPI:1598701419
Name:ORTH, KIMILA DENISE (RN)
Entity Type:Individual
Prefix:
First Name:KIMILA
Middle Name:DENISE
Last Name:ORTH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2247
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-0638
Mailing Address - Country:US
Mailing Address - Phone:503-519-6038
Mailing Address - Fax:503-637-3378
Practice Address - Street 1:26951 SE FORRESTER RD
Practice Address - Street 2:
Practice Address - City:BORING
Practice Address - State:OR
Practice Address - Zip Code:97009-9114
Practice Address - Country:US
Practice Address - Phone:503-637-3344
Practice Address - Fax:503-637-3378
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health