KIMBERLY L WALLER

GRANTS PASS, OR
NPI1093782914
Former NameKIMBERLY L COLPITTS
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: OR  PA01142)
Additional Taxonomies363AM0700X Physician Assistant, Medical
(Licence: NV  PA842)
Enumeration Date2006-03-01
Last Update Date2019-10-28
Business Address
Mrs. KIMBERLY L WALLER PA-C
1701 NW HAWTHORNE AVE
GRANTS PASS, OR 97526-1051
Phone number: 541-471-3455
Mailing Address
Mrs. KIMBERLY L WALLER PA-C
1701 NW HAWTHORNE AVE
GRANTS PASS, OR 97526-1051
Phone number: 541-471-3455