Search › Oregon › 1041C0700X
Kimberly Spencer
NPI 1588174569 · on the registry since 2017 · sole proprietor
Practice
- Address
- 529 Se Grand Ave Ste 300b
Portland, OR 97214 - Phone
- (971) 801-0787
- Organisation at this address
- 148835
Wild Moss Wellness Llc
Imagine If Psychotherapy LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 2
Additional practice sites
- 1507 Ne 122nd Ave, Portland, OR
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 104100000X
390200000X - Licence states on file
- OR
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2026-02-03
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon