MEDICARE: KIMBERLY STEWART

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1649832890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY STEWART

Provider Business Mailing Address
First Line	:	4423 N BORTHWICK AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97217-3019
Country	:	US
Telephone Number	:	503-789-0671
Fax Number	:

Provider Business Practice Location Address
First Line	:	4423 N BORTHWICK AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97217-3019
Country	:	US
Telephone Number	:	503-789-0671
Fax Number	:

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

Provider Enumeration Date	:	07/08/2019
Last Update Date	:	07/08/2019

Similar Medicare Providers

1205123031 — DONALD JAMES GREEN
Practice Location Address:

246 SAINT JOHN ST
PORTLAND, ME
04102-3019

Practice Phone: 207-773-9660
Practice Fax:

1881981249 — MICAH WELLS HOGAN LMT
Practice Location Address:

124 SW YAMHILL ST
PORTLAND, OR
97204-3019

Practice Phone: 541-771-9869
Practice Fax:

1649523564 — O'NEILL ORIENTAL MEDICINE
Practice Location Address:

124 SW YAMHILL ST , SUITE 200
PORTLAND, OR
97204-3019

Practice Phone: 503-313-5984
Practice Fax:

1093055840 — MICHAEL IAN GILL LAC
Practice Location Address:

124 SW YAMHILL ST
PORTLAND, OR
97204-3019

Practice Phone: 971-279-3591
Practice Fax:

1225479900 — KRISTA NICOLE RADETICH LMT
Practice Location Address:

124 SW YAMHILL ST STE 200
PORTLAND, OR
97204-3019

Practice Phone: 971-409-6725
Practice Fax:

1114492519 — MAPLE HOLLOW REHABILITATION AND NURSING LLC
Practice Location Address:

34 NE 20TH AVE
PORTLAND, OR
97232-3019

Practice Phone: 503-231-0276
Practice Fax:

Directions to “ KIMBERLY STEWART ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.