Individual
DR. KENNETH RICHARDS STEVENS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD., KPV4, RADIATION MEDICINE, PORTLAND, OR 97239-3098
(503) 494-8756
(503) 346-0237
Mailing address
3181 SW SAM JACKSON PARK RD., KPV4, RADIATION MEDICINE, PORTLAND, OR 97239-3098
(503) 494-8756
(503) 346-0237
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD07059
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048913
—
OR
Enumeration date
09/05/2007
Last updated
09/05/2007
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