MEDICARE: KIM EHLER KIM EHLER, L.M.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	173C00000X	Reflexologist	7668	OR

General Provider Information

NPI Number	:	1326282658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIM EHLER KIM EHLER, L.M.T.

Provider Business Mailing Address
First Line	:	21185 NW WEST UNION RD
Second Line	:
City	:	HILLSBORO
State	:	OR
Zip	:	97124
Country	:	US
Telephone Number	:	503-997-5675
Fax Number	:

Provider Business Practice Location Address
First Line	:	3375 NW 147TH PL
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97229-0907
Country	:	US
Telephone Number	:	503-997-5675
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2009
Last Update Date	:	04/30/2009

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