KENNETH DAVID HOLLADAY (NPI# 1275628380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275628380 |
| Entity Type | Individual |
| Full Name | KENNETH DAVID HOLLADAY |
| Credential | M.D. |
| Practice Address |
9830 Ne Cascades Pkwy Suite 200 Portland OR 97220-6832 |
| Practice Telephone | 5032398101 |
| Mailing Telephone | 5032398101 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2013-02-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
156792 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | BC | 421545189 | 01 |
| AK | MD24422 | 05 | |
| AETNA | 20861000 | 01 | |
| COMPSYCH | 239264 | 01 | |
| AK | MH9931 | 05 |
| Street Address |
9830 NE CASCADES PKWY SUITE 200 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97220-6832 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093190787 | Sarah Manlupig | Counselor | 9830 Ne Cascades Pkwy, 200, Portland, OR 97220-6832 | 2015-07-23 |
| 1831581651 | Molly Seel | Social Worker | 9830 Ne Cascades Pkwy, Suite 200, Portland, OR 97220-6832 | 2015-03-03 |
| 1194122911 | Danielle Dierking | Counselor | 9830 Ne Cascades Pkwy, Suite 200, Portland, OR 97220-6832 | 2014-11-21 |
| 1801290820 | Liesl Hope Thorsen | Counselor | 9830 Ne Cascades Pkwy, Ste. 200, Portland, OR 97220-6832 | 2014-10-20 |
| 1003225368 | Jessica Ann Wilson | Social Worker | 9830 Ne Cascades Pkwy, Ste 200, Portland, OR 97220-6832 | 2014-08-11 |
| 1780092296 | Robert Thieman | Counselor | 9830 Ne Cascades Pkwy, Ste. 200, Portland, OR 97220-6832 | 2014-07-28 |
| 1366867368 | Kyle Bargmann | Social Worker | 9830 Ne Cascades Pkwy, Ste 200, Portland, OR 97220-6832 | 2014-02-27 |
| 1750716544 | Amanda Maree Ferrat | Social Worker | 9830 Ne Cascades Pkwy, Ste 200, Portland, OR 97220-6832 | 2013-09-11 |
| 1932545951 | Ryan Grossenbacher | Behavioral Analyst | 9830 Ne Cascades Pkwy, Portland, OR 97220-6832 | 2013-05-16 |
| 1942645361 | Christopher Michael Gray | Social Worker | 9830 Ne Cascades Pkwy, Suite 200, Portland, OR 97220-6832 | 2013-04-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316569254 | Debra Shamblin | Behavioral Analyst | 150 Ne 100th Ave, Portland, OR 97220 | 2020-05-14 |
| 1336780618 | Joan Lambert | Technician | 2802 Ne 108th Avenue, Portland, OR 97220 | 2019-10-08 |
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
| 1487178711 | Andrew Shonk | Massage Therapist | 163 Ne 102nd Ave Blid V, Portland, OR 97220 | 2017-07-28 |
| 1548781693 | Greater New Hope Family Services | Lodging | 11868 Ne Sandy Blvd, Portland, OR 97220 | 2017-06-29 |
| 1245771740 | Maria Teresa Banez Salcedo | Registered Nurse | 10300 Ne Hancock Street, Portland, OR 97220 | 2017-03-16 |
| 1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
| 1962945956 | Linda Ann Oldenburg | Registered Nurse | 9515 Ne Skidmore Avenue, Portland, OR 97220 | 2016-11-23 |
| 1326493446 | Trent D. Wilson | Massage Therapist | 8401 Ne Halsey St., Suite 101, Portland, OR 97220 | 2016-04-26 |
| Find all providers in zip 97220 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831455211 | Nicholas Austin | Psychiatry & Neurology | 3181 Sw Sam Jackson Park Rd Dept Of, Portland, OR 97239-3011 | 2012-04-10 |
| 1235446303 | Ervin Gene Stubbs | Psychiatry & Neurology | 7032 Sw 3rd Ave, Portland, OR 97219-2214 | 2010-09-09 |
| 1851525620 | Sarah Morgan Schrauben | Psychiatry & Neurology | 870 Se 82nd Ave., Portland, OR 97027 | 2009-05-08 |
| 1700077328 | Hanh Ngoc Nguyen | Psychiatry & Neurology | 5410 Sw Macadam Ave Ste 200, Portland, OR 97239 | 2007-08-08 |
| 1912116013 | John Barrows Chenoweth | Psychiatry & Neurology | 5410 S.w. Macadam Ave, Ste 200, Portland, OR 97239-3825 | 2007-05-22 |
| 1043340219 | Birgit Meyer | Psychiatry & Neurology | 3415 Se Powell Blvd., Portland, OR 97202 | 2007-03-06 |
| 1518029768 | Barbara Jean Baker | Psychiatry & Neurology | 1818 Se Division St, Portland, OR 97202-1159 | 2006-12-14 |
| 1790851574 | Dena K Drasin | Psychiatry & Neurology | 6834 Se 28th Ave, Portland, OR 97202-8705 | 2006-11-25 |
| 1700966926 | Jonathan Joseph Valen | Psychiatry & Neurology | 506 Sw 6th Ave, Ste 602, Portland, OR 97204-1533 | 2006-10-16 |
| 1639264856 | Richard Randolph Sogn | Psychiatry & Neurology | 9900 Sw Wilshire Street, Suite 260, Portland, OR 97225-5025 | 2006-10-04 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.