Healthcare Provider Details

I. General information

NPI: 1770488850
Provider Name (Legal Business Name): KEENAN DOUGLAS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2865 DAGGETT AVE
KLAMATH FALLS OR
97601-1106
US

IV. Provider business mailing address

2922 FRONT ST
KLAMATH FALLS OR
97601-1276
US

V. Phone/Fax

Practice location:
  • Phone: 541-882-6311
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License NumberRPH-0019124
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: