Provider Demographics
NPI:1851558563
Name:PALMER, KIRIN N (MD)
Entity Type:Individual
Prefix:
First Name:KIRIN
Middle Name:N
Last Name:PALMER
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 1:355 NW ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-6256
Mailing Address - Country:US
Mailing Address - Phone:503-420-8667
Mailing Address - Fax:971-512-3246
Practice Address - Street 1:15405 SW 116TH AVE STE 116
Practice Address - Street 2:
Practice Address - City:KING CITY
Practice Address - State:OR
Practice Address - Zip Code:97224-2600
Practice Address - Country:US
Practice Address - Phone:503-420-8667
Practice Address - Fax:971-512-3246
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD167618208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORMD21148OtherSTATE LICENSE