Kalin Burkhardt Clark
Health Psychologist Clinical Psychologist
5211 Ne Glisan St Bldg C
Portland
, Oregon 97213-3052
Kalin Burkhardt Clark
Health Psychologist Clinical Psychologist
5211 Ne Glisan St Bldg C
Portland
, Oregon 97213-3052
(503) 215-6494
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About
Features
Specialties
- Clinical Psychologist
- Health Psychologist
Languages spoken
- English
Location
First Address
- Kalin Burkhardt Clark
- Po Box 3158
- Portland, OR
- Zip : 97208-3158
- Phone : (503) 215-6494
Second Address
- Kalin Burkhardt Clark
- 5211 Ne Glisan St Bldg C
- Portland, OR
- Zip : 97213-3052
- Phone : (503) 215-7230
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103G00000X | Clinical Psychologist | 3096 | OR |
| Y | 103TC0700X | Clinical Psychologist | 3096 | OR |
| N | 103TH0004X | Health Psychologist | PS01577 | RI |
National Provider Identifier
| NPI | 1629446927 |
|---|---|
| Provider Name | Kalin Burkhardt Clark |
| First Address | Portland, OR 97208-3158 |
| Second Address | Portland, OR 97213-3052 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/09/2015 |
| Last Update Date | 26/12/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.