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General NPI Number Information
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NPI Number | 1902835838
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Entity Type | Individual
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Provider Name | KATHLEEN PATRICIA KERWAN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 7150 SW HAMPTON ST STE 200
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City | TIGARD
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State | OR
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Zip | 97223-8378
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Country | US
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Telephone | 503-482-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 11145 SW MEADOWBROOK DR APT 5
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City | TIGARD
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State | OR
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Zip | 97224-3349
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Country | US
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Telephone | 503-780-3294
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 200950047NP
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License Number State | OR
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