Individual
DR. KEVIN J BAXTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
10 PIER 1 STE 301, ASTORIA, OR 97103-6338
(503) 741-3570
(503) 741-3569
Mailing address
PO BOX 450, ASTORIA, OR 97103-0450
(503) 741-3570
(503) 741-3569
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO24314
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227275
—
OR
01
—
DO24314
STATE LICENSE
OR
Enumeration date
06/30/2005
Last updated
08/16/2022
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