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Organization

RICHARD KOLBELL, PHD, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICHARD KOLBELL PHD (OWNER)
(503) 284-2372
Entity
Organization

Contact information

Practice address
1923 NE BROADWAY ST, PORTLAND, OR 97232-1501
(503) 284-2371
Mailing address
1923 NE BROADWAY ST, PORTLAND, OR 97232-1501
(503) 284-2371

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
1084
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
123823
OREGON STATE DEPARTMENT OF HUMAN SERVICES
OR
Enumeration date
05/06/2011
Last updated
05/06/2011
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