MEDICARE: DR. KEIFONG WILLIAM SEETO MD

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	2084N0400X	Neurology Physician	MD20167	OR
2	2084N0600X	Clinical Neurophysiology Physician	MD20167	OR
3	2084S0012X	Sleep Medicine (Psychiatry & Neurology) Physician	MD 20167	OR

Other Identifiers

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

General Provider Information

NPI Number	:	1962447730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEIFONG WILLIAM SEETO MD

Provider Business Mailing Address
First Line	:	960 LIBERTY ST SE
Second Line	:	SUITE 140
City	:	SALEM
State	:	OR
Zip	:	97302-4165
Country	:	US
Telephone Number	:	503-585-0575
Fax Number	:	503-585-3301

Provider Business Practice Location Address
First Line	:	960 LIBERTY ST SE
Second Line	:	SUITE 140
City	:	SALEM
State	:	OR
Zip	:	97302-4165
Country	:	US
Telephone Number	:	503-585-0575
Fax Number	:	503-585-3301

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

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	06/24/2014

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