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Organization
KARTINI CLINIC PC
Active
Organization
KARTINI CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNA GREENE (COO)
(503) 249-8851
Entity
Organization
Contact information
Practice address
3530 N VANCOUVER AVE STE 400, PORTLAND, OR 97227-1798
(503) 249-8851
(503) 282-3409
Mailing address
3530 N VANCOUVER AVE STE 400, PORTLAND, OR 97227-1798
(503) 249-8851
(503) 282-3409
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
OR
208000000X
Pediatrics Physician
—
OR
2080A0000X
Pediatric Adolescent Medicine Physician
—
OR
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
OR
Other
Enumeration date
10/31/2006
Last updated
07/21/2022
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