Individual
ALAN P KAISER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP, LCSW
Contact information
Practice address
1340 SW BERTHA BLVD, SUITE 101, PORTLAND, OR 97219-2039
(503) 245-5356
(503) 245-5393
Mailing address
3011 SW VESTA ST, PORTLAND, OR 97219-8926
(503) 245-5356
(448) 407-3498
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
001741
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP 091007250N6
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
077938
—
OR
Enumeration date
10/10/2006
Last updated
08/03/2022
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