Provider Demographics
NPI:1760356836
Name:KALLPA CONNECTION
Entity type:Organization
Organization Name:KALLPA CONNECTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:IXTLAHUAC
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:503-395-8771
Mailing Address - Street 1:1916 NE 125TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-1807
Mailing Address - Country:US
Mailing Address - Phone:503-395-8771
Mailing Address - Fax:
Practice Address - Street 1:1916 NE 125TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-1807
Practice Address - Country:US
Practice Address - Phone:503-395-8771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty