Provider Demographics
NPI:1124468509
Name:KLEPPER, EMET JOEL (LMT)
Entity type:Individual
Prefix:MR
First Name:EMET
Middle Name:JOEL
Last Name:KLEPPER
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7110 SW FIR LOOP
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8084
Mailing Address - Country:US
Mailing Address - Phone:503-819-2904
Mailing Address - Fax:
Practice Address - Street 1:7110 SW FIR LOOP
Practice Address - Street 2:SUITE 210
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-8084
Practice Address - Country:US
Practice Address - Phone:503-819-2904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR12752171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor