Provider Demographics
NPI:1659556843
Name:KEMMER, WILLIAM JOSEPH
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:KEMMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:BILLY
Other - Middle Name:
Other - Last Name:KEMMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3801 NE 75TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-5763
Mailing Address - Country:US
Mailing Address - Phone:503-380-1440
Mailing Address - Fax:
Practice Address - Street 1:5725 NE PRESCOTT ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97218-2229
Practice Address - Country:US
Practice Address - Phone:503-548-8085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator