Individual
MR. BRENDAN CHARLES KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC II, BS
Contact information
Practice address
3793 RIVER RD N, SUITE A, KEIZER, OR 97303-4827
(503) 304-7002
(503) 304-7049
Mailing address
3793 RIVER RD N, SUITE A, KEIZER, OR 97303-4827
(503) 304-7002
(503) 304-7049
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4150510000
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4150150000
—
OR
Enumeration date
09/08/2010
Last updated
09/08/2010
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