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Individual

DR. KASEY CHANNARA LUY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
10260 SW GREENBURG RD STE 400, PORTLAND, OR 97223-5514
(503) 293-8481
Mailing address
2315 TANNLER DR, WEST LINN, OR 97068-4164
(503) 866-9809

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2567
OR

Other

Enumeration date
01/14/2015
Last updated
04/06/2021
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