Kordell Kennemer PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1633 Issued in OR

Legal business name

KORDELL KENNEMER PSYD

Practice address

619 Madison St Ste 108
Oregon City, OR 97045

Phone

(503) 303-4257

Fax

(503) 387-3957

NPI assigned

Jun 4, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Cindy Michele Van Drimmelen

Title

Administrator

Phone

(503) 303-4257

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530057600000",
    "number": "1992297121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 MADISON ST STE 108",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970452354",
            "telephone_number": "503-303-4257",
            "fax_number": "503-387-3957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 MADISON ST STE 108",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "97045",
            "telephone_number": "503-303-4257",
            "fax_number": "503-387-3957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KORDELL KENNEMER PSYD",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-04",
        "last_updated": "2018-06-27",
        "status": "A",
        "authorized_official_last_name": "VAN DRIMMELEN",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "MICHELE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "503-303-4257",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Knox
• Lee Knox, PHD
• Catherine Marie Koch
• Jenna Goodman Koerner
• Hunter Koontz, RBT
• Joe Koziol
• Marscia Michelle Kozlik, RDH
• Michael Kozlowski, PH.D.
• Paula Kraft, CCC-SLP
• Zachary Krebs, L.AC

• Clinical Psychologist in Oregon City, OR
• Providers in Oregon City, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.