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NPI Code Detail

MEDICARE: CARMEN G KENDALL MD

MEDICARE: CARMEN G KENDALL MD
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
1207Q00000XFamily Medicine PhysicianMD25543OR

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00261172OTHERORRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780639575
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARMEN G KENDALL MD
Provider Business Mailing Address
First Line : PO BOX 3158
Second Line :
City : PORTLAND
State : OR
Zip : 97208-3158
Country : US
Telephone Number : 503-215-6494
Fax Number : 503-215-6644
Provider Business Practice Location Address
First Line : 5555 NE ELAM YOUNG PKWY
Second Line :
City : HILLSBORO
State : OR
Zip : 97124-6452
Country : US
Telephone Number : 503-216-1600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2006
Last Update Date : 10/13/2021

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