Provider Demographics
NPI:1891831863
Name:KRANE, ROBERT ARTHUR
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ARTHUR
Last Name:KRANE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1716 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-1718
Mailing Address - Country:US
Mailing Address - Phone:503-657-5174
Mailing Address - Fax:
Practice Address - Street 1:5120 SE 118TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97266-3250
Practice Address - Country:US
Practice Address - Phone:503-762-3431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator