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NPI Code Detail

MEDICARE: DR. MICHELLE C. KEYS DMD

MEDICARE: DR. MICHELLE C. KEYS DMD
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
1122300000XDentistD7076OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508947102
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHELLE C. KEYS DMD
Provider Business Mailing Address
First Line : 12710 SE DIVISION ST
Second Line :
City : PORTLAND
State : OR
Zip : 97236-3134
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12710 SE DIVISION ST
Second Line :
City : PORTLAND
State : OR
Zip : 97236-3134
Country : US
Telephone Number : 503-988-3410
Fax Number : 503-988-5903
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2006
Last Update Date : 07/08/2007

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