Provider Demographics
NPI:1215097084
Name:HINDMAN, KIMBERLY JOAN (ND, LAC)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:JOAN
Last Name:HINDMAN
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9320 SW BARBUR BLVD.
Mailing Address - Street 2:SUITE 165
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219
Mailing Address - Country:US
Mailing Address - Phone:503-784-1027
Mailing Address - Fax:503-293-7205
Practice Address - Street 1:9320 SW BARBUR BLVD.
Practice Address - Street 2:SUITE 165
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219
Practice Address - Country:US
Practice Address - Phone:503-784-1027
Practice Address - Fax:503-293-7205
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00798171100000X
OR1360175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist