KORDELL NOLTAN KENNEMER (NPI# 1730282138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730282138 |
| Entity Type | Individual |
| Full Name | KORDELL NOLTAN KENNEMER |
| Credential | PSYD |
| Practice Address |
619 Madison St Ste 108 Oregon City OR 97045 |
| Mailing Address |
Po Box 14900 Dhs Ofs Irs Dba Oregon State Hospital Salem OR 97309-5016 |
| Practice Telephone | 5033873957 |
| Mailing Telephone | 5039459840 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2018-05-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
1633 | OR | Behavioral Health & Social Service Providers |
| Street Address |
619 MADISON ST STE 108 |
| City | OREGON CITY |
| State | OR |
| Zip Code | 97045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992297121 | Kordell Kennemer Psyd | Psychologist | 619 Madison St Ste 108, Oregon City, OR 97045 | 2018-06-04 |
| 1679070437 | Mallory & White PC | Clinic/Center | 619 Madison St Ste 108, Oregon City, OR 97045-2354 | 2018-04-09 |
| 1992853402 | Loren E Mallory | Clinical Neuropsychologist | 619 Madison St Ste 108, Oregon City, OR 97045-2354 | 2007-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528625621 | Dylan Wile | Physical Therapist | 19721 Or 213, Oregon City, OR 97045 | 2019-05-23 |
| 1952871576 | April Saylor | Dental Hygienist | 15530 S. Morel Dr, Oregon City, OR 97045 | 2018-11-27 |
| 1598251688 | Sara Noelle Wetten | Dental Assistant | 1900 Mclouglin Blvd #68, Oregon City, OR 97045 | 2018-07-02 |
| 1649761941 | Carol Ann Cranfill | Specialist | 1001 Molalla Ave. Ste 206, Oregon City, OR 97045 | 2018-05-22 |
| 1790286029 | Kathleen Walker | Registered Nurse | 110 Beaverceek Rd., Oregon City, OR 97045 | 2018-02-22 |
| 1174032429 | Amanda Brannin | Dental Hygienist | 15018 Pebble Beach Dr, Oregon City, OR 97045 | 2017-09-28 |
| 1003332669 | Clackamas Medical Supplies | Durable Medical Equipment & Medical Supplies | 2050 Beavercreek Rd. Ste 101-385, Oregon, OR 97045 | 2017-08-16 |
| 1154870129 | Staci S Meador | Nurse Practitioner | 1508 Division St Ste 200, Oregon City, OR 97045 | 2016-10-01 |
| 1821541939 | Samuel R. Sabo | General Practice | 18171 Waldow Rd., Oregon City, OR 97045 | 2016-07-26 |
| 1619339967 | Carly Chambers | Physical Therapist | 1630 S Beavercreeak Rd, Suite A, Oregon City, OR 97045 | 2016-03-25 |
| Find all providers in zip 97045 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356746317 | Capacity Solutions LLC | Psychologist | 14426 Blue Mountain Way, Oregon City, OR 97045-3078 | 2014-11-02 |
| 1891763595 | Barbara Breck | Psychologist | 2051 Kaen Rd Fl 1, Oregon City, OR 97045-4035 | 2006-03-09 |
| 1568001915 | Meghan Crawford, Psyd, LLC | Psychologist | 702 John Adams St Unit A, Oregon City, OR 97045-1955 | 2020-01-02 |
| 1992297121 | Kordell Kennemer Psyd | Psychologist | 619 Madison St Ste 108, Oregon City, OR 97045 | 2018-06-04 |
| 1225547524 | Timofey Sergeyevich Galuza | Psychologist | 14279 Glen Oak Rd, Oregon City, OR 97045-8008 | 2017-09-29 |
| 1740665132 | Elizabeth Marie Zimmerman | Psychologist | 610 High St, Oregon City, OR 97045-2241 | 2015-07-27 |
| 1780097410 | Jesse Elyse Chase | Psychologist | 1510 Division St Ste 200, Oregon City, OR 97045 | 2014-06-10 |
| 1669783718 | Shawn Adair Johnston | Psychologist | 704 Main St, Suite 305-3, Oregon City, OR 97045-1842 | 2010-06-23 |
| 1871731695 | Eric W Bergreen | Psychologist | 610 Jefferson St, Oregon City, OR 97045-2329 | 2009-02-02 |
| 1376697185 | Amy M Kobus | Psychologist | 610 Jefferson St, Willamette Valley Family Center, Oregon City, OR 97045 | 2007-01-22 |
| Find all providers in OREGON CITY | ||||
| City | OREGON CITY |
| Zip Code | 97045 |
Please comment or provide details below to improve the information on KORDELL NOLTAN KENNEMER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.