MEDICARE: STEPHEN R KEEHN DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH00001023	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	R72020	OTHER	WA	REGENCE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	33694	OTHER	WA	LABOR AND INDUSTRIES

General Provider Information

NPI Number	:	1770641730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN R KEEHN DC

Provider Business Mailing Address
First Line	:	505 CEDAR AVE STE C3
Second Line	:
City	:	MARYSVILLE
State	:	WA
Zip	:	98270-4561
Country	:	US
Telephone Number	:	360-659-8411
Fax Number	:

Provider Business Practice Location Address
First Line	:	505 CEDAR AVE STE C3
Second Line	:
City	:	MARYSVILLE
State	:	WA
Zip	:	98270-4561
Country	:	US
Telephone Number	:	360-659-8411
Fax Number	:	360-658-1033

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	01/23/2008

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Directions to “ STEPHEN R KEEHN DC” Practice Location

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