Individual
MS. TERESA CATHERINE KEANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN, PMHNP
Contact information
Practice address
3325 N INTERSATE AVE, KAISER PERMANENTE, PORTLAND, OR 97227-1099
(503) 331-6131
Mailing address
3500 N INTERSTATE AVE, PORTLAND, OR 97227-1196
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
090006025N6
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
076666
PMHNP
OR
Enumeration date
10/18/2005
Last updated
07/11/2007
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