Individual
DR. KENNETH R CHASTEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
900 SUNSET DR, LA GRANDE, OR 97850-1362
(541) 963-8421
Mailing address
900 SUNSET DR, P.O. BOX 3290, LA GRANDE, OR 97850-1362
(541) 963-8421
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD23491
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
297575
—
OR
01
—
9001CHA
CHAMPUS
OR
Enumeration date
06/25/2006
Last updated
07/09/2007
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