Individual
ALICE KEYS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2415 SE 43RD AVE, PORTLAND, OR 97206-1600
(503) 238-0769
(503) 963-7711
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 963-2575
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD14375
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005285
—
OR
Enumeration date
11/30/2006
Last updated
04/17/2008
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