Provider Demographics
NPI:1063614451
Name:KLEIN, STAR ANN (MA)
Entity type:Individual
Prefix:MRS
First Name:STAR
Middle Name:ANN
Last Name:KLEIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10456 SW 63RD DRIVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-1552
Mailing Address - Country:US
Mailing Address - Phone:503-490-6068
Mailing Address - Fax:
Practice Address - Street 1:10456 SW 63RD DRIVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219
Practice Address - Country:US
Practice Address - Phone:503-490-6068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management