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NPI Code Detail

MEDICARE: MR. ROBERT CASEY KENDALL MSP

MEDICARE: MR. ROBERT CASEY KENDALL MSP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker
2101Y00000XCounselor

General Provider Information

NPI Number : 1750689014
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT CASEY KENDALL MSP
Provider Business Mailing Address
First Line : 209 SW 4TH AVE STE 520
Second Line :
City : PORTLAND
State : OR
Zip : 97204-1825
Country : US
Telephone Number : 503-680-7360
Fax Number :
Provider Business Practice Location Address
First Line : 209 SW 4TH AVE STE 520
Second Line :
City : PORTLAND
State : OR
Zip : 97204-1825
Country : US
Telephone Number : 503-680-7360
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2011
Last Update Date : 10/08/2019

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Directions to “ MR. ROBERT CASEY KENDALL MSP” Practice Location

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