Provider Demographics
NPI:1093003691
Name:KREML, WILIAM D
Entity Type:Individual
Prefix:MR
First Name:WILIAM
Middle Name:D
Last Name:KREML
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:BILL
Other - Middle Name:D
Other - Last Name:KREML
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:14800 NW CORNELL RD APT 15B
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-5473
Mailing Address - Country:US
Mailing Address - Phone:702-635-6882
Mailing Address - Fax:
Practice Address - Street 1:8915 SW CENTER ST
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-6307
Practice Address - Country:US
Practice Address - Phone:503-726-3740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-16
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome Health