| Peggy E Kelley, MD | |
|
9427 Sw Barnes Rd Ste 395, Portland, OR 97225-6652 | |
| (503) 216-6050 | |
| Not Available |
| Full Name | Peggy E Kelley |
|---|---|
| Gender | Female |
| Speciality | Otolaryngology - Pediatric Otolaryngology |
| Location | 9427 Sw Barnes Rd Ste 395, Portland, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689777476 | NPI | - | NPPES |
| 01373687 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207YP0228X | Otolaryngology - Pediatric Otolaryngology | 37368 (Colorado) | Secondary |
| 207YP0228X | Otolaryngology - Pediatric Otolaryngology | MD196930 (Oregon) | Primary |
| Entity Name | Providence Health & Services Oregon |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023488343 PECOS PAC ID: 0648183608 Enrollment ID: O20031106000652 |
| Entity Name | Providence Health & Services - Oregon |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114015971 PECOS PAC ID: 9335057447 Enrollment ID: O20031117000153 |
| Mailing Address | Practice Location Address |
|---|---|
| Peggy E Kelley, MD Po Box 3158, Portland, OR 97208-3158 Ph: (503) 215-6494 | Peggy E Kelley, MD 9427 Sw Barnes Rd Ste 395, Portland, OR 97225-6652 Ph: (503) 216-6050 |
David Wei Kuo Lin, M.D. Otolaryngology Medicare: Medicare Enrolled Practice Location: 3600 N Interstate Ave, Interstate Medical Office Central, Portland, OR 97227 Phone: 503-331-6085 | |
Zipei Feng, MD, PHD Otolaryngology Medicare: Medicare Enrolled Practice Location: 9155 Sw Barnes Rd Ste 536, Portland, OR 97225 Phone: 503-935-8100 Fax: 503-935-8110 | |
Mr. Michael Lee Mcdonald, M.D. Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 10101 Se Main St, # 2004, Portland, OR 97216 Phone: 503-257-3204 Fax: 503-255-7208 | |
Dr. Duane Allen Lundeberg, MD Otolaryngology Medicare: Medicare Enrolled Practice Location: 2222 Nw Lovejoy St, Suite #622, Portland, OR 97210 Phone: 503-229-8455 Fax: 503-229-7028 | |
Brian Jacob Stater, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 9155 Sw Barnes Rd Ste 536, Portland, OR 97225 Phone: 503-935-8100 Fax: 503-935-8110 | |
Dr. Edsel Uisuk Kim, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 9155 Sw Barnes Rd Ste 536, Portland, OR 97225 Phone: 503-935-8100 Fax: 503-935-8110 | |
James Isaac Cohen, MD Otolaryngology Medicare: Medicare Enrolled Practice Location: 3181 Sw Sam Jackson Park Rd, Ohsu Pv-01, Portland, OR 97239 Phone: 503-494-5355 Fax: 503-494-4631 |