Kordell Kennemer Psyd | |
619 Madison St Ste 108 Oregon City OR 97045 | |
(503) 303-4257 | |
(503) 387-3957 |
Full Name | Kordell Kennemer Psyd |
---|---|
Speciality | Psychologist - Clinical |
Location | 619 Madison St Ste 108, Oregon City, Oregon |
Authorized Official Name and Position | Cindy Michele Van Drimmelen (ADMINISTRATOR) |
Authorized Official Contact | 5033034257 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Kordell Kennemer Psyd 619 Madison St Ste 108 Oregon City OR 97045-2354 Ph: (503) 303-4257 | Kordell Kennemer Psyd 619 Madison St Ste 108 Oregon City OR 97045 Ph: (503) 303-4257 |
NPI Number | 1992297121 |
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Provider Enumeration Date | 06/04/2018 |
Last Update Date | 06/27/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1992297121 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 1633 (Oregon) | Primary |
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