Individual
KATHARINE J KERANEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8182
(503) 494-0028
Mailing address
3181 SW SAM JACKSON PARK RD, MAILCODE SJH-2, PORTLAND, OR 97239-3011
(503) 494-4910
(503) 494-8368
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA01420
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288680400
—
MN
Enumeration date
06/17/2006
Last updated
05/24/2022
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