Kordell Kennemer Psyd
Psychologist, Clinical in Oregon City, OR. Organization (NPI-2).
NPI number1992297121
StatusActive
Last updated in NPPESJun 27, 2018
Details
- NPI
- 1992297121
- Entity type
- Organization (NPI-2)
- Legal business name
- Kordell Kennemer Psyd
- Organization subpart
- No
- Enumeration date
- Jun 4, 2018
- Last updated
- Jun 27, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 1633 | OR | Yes |
Practice location
619 Madison St Ste 108Oregon City, OR 97045
Phone 503-303-4257 · Fax 503-387-3957
Mailing address
619 Madison St Ste 108Oregon City, OR 97045-2354
Phone 503-303-4257 · Fax 503-387-3957
Authorized official
Cindy Michele Van Drimmelen
Administrator
5033034257
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