Individual
MR. KERRY BEN CALLAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
541 NE 20TH AVE, SUITE 210, PORTLAND, OR 97232
(503) 233-6940
(503) 236-2676
Mailing address
800 SW 13TH AVE, PORTLAND, OR 97205-1902
(503) 221-0161
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16630
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
043484
—
OR
01
—
49534
WA DEPT. L&I
WA
05
—
8138299
—
WA
Enumeration date
02/22/2006
Last updated
05/24/2018
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