Provider Demographics
NPI:1073793832
Name:KALLEN, DEBORAH (MSCCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:
Last Name:KALLEN
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4234 NE 70TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97218-3669
Mailing Address - Country:US
Mailing Address - Phone:503-803-1991
Mailing Address - Fax:
Practice Address - Street 1:KAISER SUNNYSIDE MEDICAL CENTER
Practice Address - Street 2:10180 S.E. SUNNYSIDE ROAD
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015
Practice Address - Country:US
Practice Address - Phone:503-571-3820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP726235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist