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Individual

CHARLES KENNETH LINEHAN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
92659 HIGHWAY 202, ASTORIA, OR 97103-8522
(503) 325-3902
(503) 325-3902
Mailing address
92659 HIGHWAY 202, ASTORIA, OR 97103-8522
(503) 325-3902
(503) 325-3902

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD 05254
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
239848
OR
Enumeration date
05/20/2006
Last updated
07/09/2007
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