Provider Demographics
NPI:1174380232
Name:HARVEY, KEMA
Entity type:Individual
Prefix:
First Name:KEMA
Middle Name:
Last Name:HARVEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10445 NE 6TH DR APT 1204
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-1150
Mailing Address - Country:US
Mailing Address - Phone:971-222-9012
Mailing Address - Fax:
Practice Address - Street 1:5257 NE MLK STE 202E
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97211-3283
Practice Address - Country:US
Practice Address - Phone:971-222-9012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health