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Individual

KAYCE A SPEAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
10803 SE CHERRY BLOSSOM DRIVE, PORTLAND, OR 97216-3107
(503) 261-7200
(503) 261-7249
Mailing address
10803 SE CHERRY BLOSSOM DRIVE, PORTLAND, OR 97216-3107
(503) 261-7200
(503) 261-7249

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD192491
OR
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500764435
OR
01
MD192491
OREGON MEDICAL BOARD LICENSE
OR
Enumeration date
04/12/2016
Last updated
08/14/2019
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