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General NPI Number Information
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NPI Number | 1720407166
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Entity Type | Individual
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Provider Name | KIMBERLY ANN KRIPPS MD
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Gender | Female
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Dates
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Enumeration Date | 04/14/2014
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | 3181 SW SAM JACKSON PARK RD, 4502/L103
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City | PORTLAND
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State | OR
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Zip | 97239
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Country | US
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Telephone | 503-494-7703
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Fax |
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Provider Business Mailing Address
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Address Line | 3181 SW SAM JACKSON PARK RD, 4502/L103
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City | PORTLAND
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State | OR
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Zip | 97239
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Country | US
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Telephone |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD198321
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | DR.0058039
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207SG0201X
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Taxonomy Name | Clinical Genetics (M.D.) Physician
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License Number | MD198321
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License Number State | OR
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