Kennedy, Mallory
Kennedy, Mallory is an sole proprietor health care provider with primary practice located at 4216 Ne 24Th Ave , Portland OR 97211-6414. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Kennedy, Mallory can be contacted via phone (845) 893-7389.Contact Information
Primary practice address
4216 Ne 24Th Ave
Portland OR 97211-6414
Phone: (845) 893-7389
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 225XP0200X | 233754 | Oregon |
Profile Details
| NPI number | 1205192283 |
|---|---|
| LBN Legal business name | Kennedy, Mallory |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 4th, 2012 |
| Last updated | Apr 11th, 2024 - about 5 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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