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General NPI Number Information
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NPI Number | 1619270592
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Entity Type | Individual
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Provider Name | KIMBERLY JOYCE RONHOVDEE
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Gender | Female
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Dates
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Enumeration Date | 12/14/2010
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Last Update Date | 12/27/2017
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Provider Practice Location Address
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Address Line | 696 5TH ST
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City | LAKE OSWEGO
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State | OR
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Zip | 97034-2308
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Country | US
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Telephone | 503-545-4835
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Fax |
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Provider Business Mailing Address
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Address Line | 4540 OREGON TRAIL PL
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City | BOISE
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State | ID
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Zip | 83716-5657
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Country | US
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Telephone | 503-545-4835
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 92365
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License Number State | ID
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