| Kennemer & Smith Psychological Services Llc | |
|
619 Madison St Ste 108 Oregon City OR 97045-2354 | |
| (503) 303-4257 | |
| (503) 387-3957 |
| Full Name | Kennemer & Smith Psychological Services Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 619 Madison St Ste 108, Oregon City, Oregon |
| Authorized Official Name and Position | Alene Cerasuolo (OFFICE ADMINISTRATOR) |
| Authorized Official Contact | 5033034257 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kennemer & Smith Psychological Services Llc 619 Madison St Ste 108 Oregon City OR 97045-2354 Ph: (503) 303-4257 | Kennemer & Smith Psychological Services Llc 619 Madison St Ste 108 Oregon City OR 97045-2354 Ph: (503) 303-4257 |
| NPI Number | 1962004358 |
|---|---|
| Provider Enumeration Date | 11/11/2020 |
| Last Update Date | 11/16/2020 |
| Certification Date | 11/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962004358 | NPI | - | NPPES |
| 500602612 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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