Individual
DR. HAGEN KENNECKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MHA, FRCPC
Contact information
Practice address
1130 NW 22ND AVE STE 150, PORTLAND, OR 97210-2974
(971) 262-9600
(971) 262-9601
Mailing address
1400 SW 5TH AVE STE 500, PORTLAND, OR 97201-5537
(866) 617-6855
(503) 346-8015
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
60729732
WA
207RX0202X
Medical Oncology Physician
Primary
MD203393
OR
Other
Enumeration date
05/12/2017
Last updated
02/06/2024
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