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General NPI Number Information
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NPI Number | 1366865941
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Entity Type | Individual
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Provider Name | KASEY SERDAR PH.D.
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Gender | Female
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Dates
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Enumeration Date | 02/02/2014
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 2705 E. BURNSIDE ST. SUITE 206 #33
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City | PORTLAND
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State | OR
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Zip | 97214
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Country | US
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Telephone | 410-989-3905
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Fax |
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Provider Business Mailing Address
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Address Line | 1650 NW 21ST AVE APT 610
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City | PORTLAND
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State | OR
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Zip | 97209-2291
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Country | US
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Telephone | 410-989-3905
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 05209
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 05209
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License Number State | MD
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