Provider Demographics
NPI:1245247956
Name:WOODLEY, KIMBERLY KAREN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:KAREN
Last Name:WOODLEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:KIMBERLY
Other - Middle Name:KAREN
Other - Last Name:LEBRUN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2139 W BURNSIDE ST APT 406
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-5547
Mailing Address - Country:US
Mailing Address - Phone:205-999-2525
Mailing Address - Fax:
Practice Address - Street 1:3710 SW VETERANS HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239
Practice Address - Country:US
Practice Address - Phone:503-273-5201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14738183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist