Individual
MYRON DEAN KIRKWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
14525 SW MILLIKAN WAY # 9658, BEAVERTON, OR 97005-2343
(503) 507-3117
(866) 336-9931
Mailing address
14525 SW MILLIKAN WAY # 9658, BEAVERTON, OR 97005-2343
(503) 507-3117
(866) 336-9931
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
091006974
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100212
—
OR
01
—
840229000
REGENCE BCBSO
OR
Enumeration date
03/31/2006
Last updated
02/02/2010
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