Individual provider · Type 1 NPI

Kim David Sperry

Mental Health Counselor · Portland, OR

NPI number 1164577524 Active

Practice location

412 SW 12th Ave
Portland, OR 97205-2329

Fax (503) 445-0749

Mailing address

232 NW 6th Ave
Portland, OR 97209-3609

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed
Psychiatric/Mental Health Registered Nurse 163WP0808X83038439RN (OR)

Mental Health Counselor: Definition to come...

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About NPI 1164577524

Kim David Sperry's National Provider Identifier is 1164577524, issued on Jan 24, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on Feb 5, 2009.