Provider Demographics
NPI:1447068838
Name:KAPPLER, DORIAN
Entity type:Individual
Prefix:MR
First Name:DORIAN
Middle Name:
Last Name:KAPPLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6604 SE RAMONA ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-5937
Mailing Address - Country:US
Mailing Address - Phone:503-932-3854
Mailing Address - Fax:
Practice Address - Street 1:6604 SE RAMONA ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-5937
Practice Address - Country:US
Practice Address - Phone:503-932-3854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172A00000X
OR2786576172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver