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Individual

KEVIN DUFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
3303 S BOND AVE, PORTLAND, OR 97239-4501
(503) 494-7772
(503) 418-3283
Mailing address
3303 S BOND AVE, PORTLAND, OR 97239-4501
(503) 494-7772
(503) 418-3283

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
00973
IA
103G00000X
Clinical Neuropsychologist
Primary
3589
OR
103G00000X
Clinical Neuropsychologist
7381301-2501
UT
103T00000X
Psychologist
00973
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
37712
WELLMARK BCBS
IA
Enumeration date
09/19/2005
Last updated
09/26/2022
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