Individual
MRS. LUCILLE I KIRCHNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1825 E 19TH ST, THE DALLES, OR 97058
(541) 506-6940
(541) 296-2636
Mailing address
PO BOX 1520, THE DALLES, OR 97058
(541) 296-7668
(541) 296-6431
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD022974E
PA
207R00000X
Internal Medicine Physician
Primary
MD154409
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008128290009
—
PA
01
—
110218192
RR MEDICARE
—
01
—
153454
BLUE SHIELD
PA
01
—
153454
HIGH MARK
—
01
—
205080
UPMC
—
05
—
218105
—
OR
Enumeration date
11/30/2006
Last updated
09/28/2011
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