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NPI Code Detail

MEDICARE: KIMBERLY ANN BULLER MSW

MEDICARE: KIMBERLY ANN BULLER MSW
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
1101YP2500XProfessional CounselorA1832OR

General Provider Information

NPI Number : 1598827289
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY ANN BULLER MSW
Provider Business Mailing Address
First Line : 2425 LANCASTER DR NE
Second Line :
City : SALEM
State : OR
Zip : 97305-1220
Country : US
Telephone Number : 503-566-2132
Fax Number : 503-566-2134
Provider Business Practice Location Address
First Line : 2425 LANCASTER DR NE
Second Line :
City : SALEM
State : OR
Zip : 97305-1220
Country : US
Telephone Number : 503-566-2132
Fax Number : 503-566-2134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2006
Last Update Date : 07/08/2007

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Directions to “ KIMBERLY ANN BULLER MSW” Practice Location

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