Provider Information for 1235268160
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Mr. DANIEL ROBERT KLINKERT M.S.W.
Sex: Male
NPI: 1235268160
Last Updated: 2021-11-16
Certification Date: 2021-11-16
Certification Date: 2021-11-16
Details
| Name | Value | |||||||||||||||||||||
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| NPI | 1235268160 | |||||||||||||||||||||
| Enumeration Date | 2007-03-05 | |||||||||||||||||||||
| NPI Type | NPI-1 Individual | |||||||||||||||||||||
| Sole Proprietor | NO | |||||||||||||||||||||
| Status | Active | |||||||||||||||||||||
| Mailing Address | 911 SW 21ST AVE APT 312 PORTLAND, OR 97205-1510 United States Phone: 313-402-6983 | Fax: | |||||||||||||||||||||
| Primary Practice Address | 917 SW OAK ST STE 303 PORTLAND, OR 97205-2806 United States Phone: 971-200-0482 | Fax: | |||||||||||||||||||||
| Secondary Practice Address(es) | 26184 OUTER DR 3716 NE MARTIN LUTHER KING JR BLVD | |||||||||||||||||||||
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