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General NPI Number Information
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NPI Number | 1932372174
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Entity Type | Organization
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Legal Business Name | KARALEE KISER LCSW PC
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Dates
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Enumeration Date | 04/09/2008
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Last Update Date | 04/09/2008
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Provider Practice Location Address
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Address Line | 5331 SW MACADAM AVE SUITE 318
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City | PORTLAND
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State | OR
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Zip | 97239-6104
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Country | US
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Telephone | 503-228-4124
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Fax | 502-228-4124
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Provider Business Mailing Address
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Address Line | 5331 SW MACADAM AVE SUITE 318
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City | PORTLAND
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State | OR
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Zip | 97239-6104
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Country | US
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Telephone | 503-228-4124
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Fax | 502-228-4124
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Authorized Official
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Title or Position | PRESIDENT
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Name | KARALEE KISER
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Credential | MSW
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Telephone | 503-228-4124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 557
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License Number State | OR
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