Individual
MRS. KERRY E M PHIFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
6400 SE LAKE RD STE 325, PORTLAND, OR 97222-2185
(503) 786-1711
Mailing address
10121 SE SUNNYSIDE RD STE 300, CLACKAMAS, OR 97015-5713
(971) 303-3107
(503) 786-9919
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
200650118NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164936
—
OR
Enumeration date
10/27/2006
Last updated
01/31/2025
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