Organization
FAMILY CARE CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROSE J KENNY MD (PHYSICIAN)
(541) 548-8088
Entity
Organization
Contact information
Practice address
1001 NW CANAL BLVD STE 101, REDMOND, OR 97756-1697
(541) 548-8088
(541) 548-8018
Mailing address
1001 NW CANAL BLVD STE 101, REDMOND, OR 97756-1697
(541) 548-8088
(541) 548-8018
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD23253
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194975037
INDIVIDUAL NPI
OR
05
—
228793
—
OR
Enumeration date
02/28/2006
Last updated
01/25/2018
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