Provider Demographics
NPI:1912180530
Name:HAPKE, KIM (ND)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:
Last Name:HAPKE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4712 NE 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-6436
Mailing Address - Country:US
Mailing Address - Phone:971-409-0908
Mailing Address - Fax:503-234-6556
Practice Address - Street 1:2700 SE 26TH AVE
Practice Address - Street 2:SUITE D
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-1288
Practice Address - Country:US
Practice Address - Phone:971-409-0908
Practice Address - Fax:503-234-6556
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1315175F00000X
WA1589175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath