John David Kinzie, MD
Psychiatry & Neurology, Psychiatry in Portland, OR. Individual provider (NPI-1).
NPI number1962417469
StatusActive
Last updated in NPPESSep 21, 2011
Details
- NPI
- 1962417469
- Entity type
- Individual (NPI-1)
- Name
- John David Kinzie
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 31, 2006
- Last updated
- Sep 21, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology, Psychiatry | MD10390 | OR | Yes |
Practice location
3181 Sw Sam Jackson Park RdPortland, OR 97239-3011
Phone 503-494-8617
Mailing address
3181 Sw Sam Jackson Park RdPortland, OR 97239-3011
Phone 503-494-6148
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