Individual
DR. JEREMY ROWE KENISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
630 N ARROWLEAF TRL, SISTERS, OR 97759-2610
(541) 549-1318
(541) 588-6002
Mailing address
PO BOX 6095, BEND, OR 97708-6095
(541) 706-5922
(541) 706-6869
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO214918
OR
207Q00000X
Family Medicine Physician
OP 60502641
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2013
Last updated
10/02/2023
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