Provider Demographics
NPI:1184481087
Name:RUND, KYRA GINEE
Entity type:Individual
Prefix:
First Name:KYRA
Middle Name:GINEE
Last Name:RUND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18600 SE MCLOUGHLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97267-6723
Mailing Address - Country:US
Mailing Address - Phone:971-255-0658
Mailing Address - Fax:971-236-8080
Practice Address - Street 1:31700 FAYETTEVILLE DR
Practice Address - Street 2:
Practice Address - City:SHEDD
Practice Address - State:OR
Practice Address - Zip Code:97377-9779
Practice Address - Country:US
Practice Address - Phone:503-208-9004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist