Whittaker, Kenneth A

Whittaker, Kenneth A is an sole proprietor health care provider with primary practice located at 506 N Villa Rd , Newberg OR 97132-1833. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Whittaker, Kenneth A can be contacted via phone (503) 554-0036.

Contact Information

Primary practice address
506 N Villa Rd Newberg OR 97132-1833
Fax: (503) 538-9257
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD19011 Oregon

Profile Details

NPI number 1073606687
LBN Legal business name Whittaker, Kenneth A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 2nd, 2006
Last updated Jun 15th, 2021 - about 4 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 1073606687 NPPES
Oregon MEDICAID 081448

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