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Contact Information

KPG OREGON, LLC
486 12TH STREET #200
ASTORIA, OR97103
 Phone: 310-975-1428
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction Medicine

207RA0401X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for KPG OREGON LLC · (Female)

NPI Number 1730552845
Status Active
Credentials
Entity Individual
Enumeration date 11/11/2015
Last updated 04/12/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • OR License # MD168198
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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