Ensroth, Kenneth Alan

Ensroth, Kenneth Alan is an individual health care provider with primary practice located at 1500 Division St Child Clinic, Oregon City OR 97045-1527. He recently has only one registered license in Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, which is considered as his primary health care specialty. Ensroth, Kenneth Alan can be contacted via phone (503) 722-3700.

Contact Information

Primary practice address
1500 Division St Child Clinic Oregon City OR 97045-1527
Phone: (503) 722-3700
Fax: (503) 722-3750
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X MD22953 Oregon

Profile Details

NPI number 1770599185
LBN Legal business name Ensroth, Kenneth Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2006
Last updated Mar 9th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770599185 NPPES
Oregon MEDICAID 287772
Oregon MEDICAID 500656755

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