Provider Demographics
NPI:1750004057
Name:CARLI, KAI DEVA (MA AT, ATR-P)
Entity type:Individual
Prefix:
First Name:KAI
Middle Name:DEVA
Last Name:CARLI
Suffix:
Gender:
Credentials:MA AT, ATR-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8915 SW CENTER ST
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-6307
Mailing Address - Country:US
Mailing Address - Phone:503-726-3690
Mailing Address - Fax:
Practice Address - Street 1:11 NE MLK BLVD STE 203
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-3579
Practice Address - Country:US
Practice Address - Phone:971-350-1122
Practice Address - Fax:971-350-3401
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health