| Kaisky | |
|
2550 Ne Mcdonald Ln Mcminnville OR 97128-2223 | |
| (503) 472-2181 | |
| Not Available |
| Full Name | Kaisky |
|---|---|
| Speciality | Clinic/center |
| Location | 2550 Ne Mcdonald Ln, Mcminnville, Oregon |
| Authorized Official Name and Position | Justin Todd Walter (OWNER) |
| Authorized Official Contact | 5038577026 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kaisky 1230 George St Woodburn OR 97071-5203 Ph: (503) 981-3603 | Kaisky 2550 Ne Mcdonald Ln Mcminnville OR 97128-2223 Ph: (503) 472-2181 |
| NPI Number | 1730856774 |
|---|---|
| Provider Enumeration Date | 08/26/2021 |
| Last Update Date | 10/08/2021 |
| Certification Date | 10/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730856774 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| 261QD0000X | Clinic/center - Dental | () | Secondary |
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