Individual
WILLIAM J KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6410 NE HALSEY ST, STE 300, PORTLAND, OR 97213-4742
(503) 215-4691
(503) 215-4846
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A10208
CA
207R00000X
Internal Medicine Physician
Primary
DO28974
OR
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
A10208
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500609867
—
OR
Enumeration date
01/10/2006
Last updated
10/08/2009
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