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Individual

SAMANTHA ALISON MCKAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
17550 PROVOST ST STE 201, LAKE OSWEGO, OR 97034-5221
(503) 872-2440
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD151730
OR
208D00000X
General Practice Physician
TRN10886
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500625457
OR
Enumeration date
08/09/2007
Last updated
05/06/2024
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