Individual
MRS. KATHLEEN KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, IBCLC
Contact information
Practice address
7150 SW DARTMOUTH ST, TIGARD, OR 97223-7614
(503) 968-3480
Mailing address
8112 SW 56TH AVE, PORTLAND, OR 97219-3223
(503) 780-3172
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
200440164RN
OR
Other
Enumeration date
04/03/2020
Last updated
04/03/2020
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