Individual
DR. KEVIN L DEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10123 SE MARKET ST, PORTLAND, OR 97216-2532
(503) 252-2004
Mailing address
1601 CUMMINS DR, STE D, MODESTO, CA 95358-6411
(888) 828-3196
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
A91503
CA
207P00000X
Emergency Medicine Physician
Primary
MD26601
OR
207P00000X
Emergency Medicine Physician
MD61248946
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005942
—
OR
01
—
210867
WA L & I
—
05
—
8460289
—
WA
01
—
858543032
REGENCE BCBS
—
01
—
8942007
WA CRIME VICTIMS
—
01
—
P00377905
RAILROAD MEDICARE
—
05
—
XPY206686
—
CA
Enumeration date
07/13/2006
Last updated
03/18/2022
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