1881814432 NPI number — DR. MARGARET MARY KELLEHER PSYD

Table of content: DR. MARGARET MARY KELLEHER PSYD (NPI 1881814432)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881814432 NPI number — DR. MARGARET MARY KELLEHER PSYD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KELLEHER
Provider First Name:
MARGARET
Provider Middle Name:
MARY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSYD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DUGGER
Provider Other First Name:
MARGARET
Provider Other Middle Name:
MARY
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PSYD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1881814432
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/10/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8624 SE 13TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORTLAND
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97202-7166
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-232-0014
Provider Business Mailing Address Fax Number:
503-232-0144

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2812 COLONIAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CENTRALIA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98531-8879
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-232-0014
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  1363 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103TC0700X , with the licence number: 0777 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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