Provider Demographics
NPI:1083745731
Name:DR. JUDITH KEMP, M.D.LLC
Entity Type:Organization
Organization Name:DR. JUDITH KEMP, M.D.LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KEMP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-615-3100
Mailing Address - Street 1:6244 NE BRIGHTON ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-5076
Mailing Address - Country:US
Mailing Address - Phone:503-615-3100
Mailing Address - Fax:503-640-4841
Practice Address - Street 1:6244 NE BRIGHTON ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-5076
Practice Address - Country:US
Practice Address - Phone:503-615-3100
Practice Address - Fax:503-640-4841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD26365207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty