Individual
CLAIRE KENNEALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
825 NE 20TH AVE, PORTLAND, OR 97232-2275
(503) 290-1900
Mailing address
6815 N VANCOUVER AVE, PORTLAND, OR 97217-1744
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/03/2019
Last updated
10/03/2019
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