Healthcare Provider Details

I. General information

NPI: 1215598735
Provider Name (Legal Business Name): KATHRYN ELIZABETH KEMP MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2019
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 NE A ST STE 100
MADRAS OR
97741-1842
US

IV. Provider business mailing address

PO BOX 4228
PORTLAND OR
97208-4228
US

V. Phone/Fax

Practice location:
  • Phone: 541-383-3005
  • Fax: 541-383-1883
Mailing address:
  • Phone: 541-383-3005
  • Fax: 541-383-1883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL11319
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: