Kristen Cole Kellenberger | Portland, OR • PECOS Search

Kristen Cole Kellenberger

Social Worker

Behavioral Health & Social Service Providers

3415 SE Powell Blvd, Portland, OR 97202-3371

(503) 234-9591 (612) 708-6181

PECOS Enrollment

Based on the most recent information from CMS, provider Kristen Cole Kellenberger does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1578861167
Provider Type
Individual
Full Name
Kellenberger, Kristen Cole
Title
Miss

Gender
Female
Sole Proprietor
No
Enumeration Date
3/4/2011
Last Updated
3/4/2011

Contact Information

Practice Location

3415 SE Powell Blvd, Portland, OR 97202-3371

Unlisted Fax

Mailing Location

745 NW 15th St, Corvallis, OR 97330-5812

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 104100000X Primary	Description Social Worker Behavioral Health & Social Service Providers	License Unlisted Issuer