Kevin W Keck, MD | |
12442 Sw Scholls Ferry Rd, Suite 100, Tigard, OR 97223-3396 | |
(503) 215-9900 | |
(503) 215-9266 |
Full Name | Kevin W Keck |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 12442 Sw Scholls Ferry Rd, Tigard, Oregon |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1427092428 | NPI | - | NPPES |
136343 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | MD21667 (Oregon) | Primary |
208000000X | Pediatrics | MD21667 (Oregon) | Primary |
Entity Name | Go Gently Medical Group Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1891397931 PECOS PAC ID: 9931510187 Enrollment ID: O20201119002756 |
Mailing Address | Practice Location Address |
---|---|
Kevin W Keck, MD Po Box 13994, Portland, OR 97213-0994 Ph: (503) 215-6494 | Kevin W Keck, MD 12442 Sw Scholls Ferry Rd, Suite 100, Tigard, OR 97223-3396 Ph: (503) 215-9900 |
Margaret Allison Baynham, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 7213 Sw Hazelfern Rd, Tigard, OR 97224 Phone: 503-214-2064 Fax: 503-598-3600 | |
Dr. Sandra Ana Antonovic, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 12442 Sw Scholls Ferry Rd, Suite 205, Tigard, OR 97223 Phone: 503-216-9140 Fax: 503-216-9145 | |
Leila Hotaki Mesch, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 12442 Sw Scholls Ferry Rd Ste 205, Tigard, OR 97223 Phone: 503-216-9140 | |
Kirsten Crowley, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 12442 Sw Scholls Ferry Rd, Suite 205, Tigard, OR 97223 Phone: 503-216-9140 Fax: 503-216-9145 | |
Carol Lynn Schriner, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 9250 Sw Hall Blvd, Tigard, OR 97223 Phone: 503-293-0161 Fax: 503-221-4451 | |
Dr. Zaid Saad Al-mulla, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 9735 Sw Shady Ln Ste 300, Tigard, OR 97223 Phone: 503-466-1779 Fax: 503-598-9030 | |
Sarah A Leffler Wagoner, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 12442 Sw Scholls Ferry Rd Ste 205, Tigard, OR 97223 Phone: 503-216-9140 |