Healthcare Provider Details

I. General information

NPI: 1619885498
Provider Name (Legal Business Name): KEYSTONE THERAPEUTIC SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40394 HILLTOP DR
LEBANON OR
97355-9102
US

IV. Provider business mailing address

40394 HILLTOP DR
LEBANON OR
97355-9102
US

V. Phone/Fax

Practice location:
  • Phone: 458-266-5545
  • Fax:
Mailing address:
  • Phone: 458-266-5545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER LLOYD
Title or Position: OWNER
Credential:
Phone: 458-266-5545