Organization
KAISER PERMANENTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN CCALLAIS (SUPERVISOR PT/OT DEPT)
(503) 571-4193
Entity
Organization
Contact information
Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 571-4190
Mailing address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
118
OR
Other
Enumeration date
05/28/2008
Last updated
06/01/2021
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