Individual
DR. KENT FORREST MECKLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8995 SW MILEY RD, SUITE 204, WILSONVILLE, OR 97070-5484
(503) 292-6295
Mailing address
7903 NW BLUE POINTE LN, PORTLAND, OR 97229-9115
(503) 292-6295
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD24567
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274822
—
OR
05
—
8381790
—
WA
05
—
MD5953R
—
AK
01
—
P00467822
RR MEDICARE
OR
Enumeration date
07/27/2006
Last updated
02/07/2016
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