Dockery, Kimberley D

Dockery, Kimberley D is an individual health care provider with primary practice located at 19250 Sw 65Th Ave Ste 300 , Tualatin OR 97062-7707. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Dockery, Kimberley D can be contacted via phone (503) 692-1242.

Contact Information

Primary practice address
19250 Sw 65Th Ave Ste 300 Tualatin OR 97062-7707
Phone: (503) 692-1242
Fax: (503) 691-3615
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 9734 Nebraska
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X T1550 Oregon

Profile Details

NPI number 1710236757
LBN Legal business name Dockery, Kimberley D
Credentials PH.D., LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 6th, 2012
Last updated Mar 12th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710236757 NPPES
Oregon MEDICAID 500705290

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