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Contact Information

KEITH L IRONSIDE JR, MD
6464 SW BORLAND RD
SUITE B2
TUALATIN, OR97062-8876
 Phone: 503-612-9676
 Fax: 866-360-3540
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sleep Specialist, PhD

173F00000X
 

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for KEITH L IRONSIDE JR · (Male)

NPI # 1639310774
Status Active
Credentials MD
Entity Individual
Enumeration date 03/19/2009
Last updated 09/17/2013 - About 13 years ago
Sole proprietor 1 Yes
Identifiers
  • OR License # MD09750
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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