Ian G Mckenna, MD | |
2801 N Gantenbein Ave, Portland, OR 97227-1623 | |
(503) 413-4121 | |
Not Available |
Full Name | Ian G Mckenna |
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Gender | Male |
Speciality | Emergency Medicine |
Location | 2801 N Gantenbein Ave, Portland, Oregon |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1912927484 | NPI | - | NPPES |
082784 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | MD20182 (Oregon) | Primary |
Entity Name | Providence Health & Services Oregon |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053862714 PECOS PAC ID: 7315856010 Enrollment ID: O20040304001330 |
Entity Name | Northwest Acute Care Specialists Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1215983200 PECOS PAC ID: 7012807373 Enrollment ID: O20040318001535 |
Entity Name | Providence Health & Services Oregon |
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Entity Type | Part A Provider - Critical Access Hospital |
Entity Identifiers | NPI Number: 1255429338 PECOS PAC ID: 7315856010 Enrollment ID: O20061104000324 |
Mailing Address | Practice Location Address |
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Ian G Mckenna, MD 6312 Sw Capitol Hwy, #502, Portland, OR 97239-1938 Ph: (503) 464-9034 | Ian G Mckenna, MD 2801 N Gantenbein Ave, Portland, OR 97227-1623 Ph: (503) 413-4121 |
Kimberly Lauren Imbesi, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-494-8211 Fax: 503-346-8021 | |
Dr. Hani Darwich, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 10123 Se Market St, Portland, OR 97216 Phone: 503-252-2004 | |
Dr. Robert Thomas Martin, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 4805 Ne Glisan St, Portland, OR 97213 Phone: 503-297-6334 Fax: 503-297-2360 | |
Dr. Jessica Slim, M.D., M.P.H. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-494-7551 Fax: 503-494-4997 | |
Robert Barriatua, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 10123 Se Market St, Portland, OR 97216 Phone: 503-252-2004 | |
Carolyn N Rhett, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1015 Nw 22nd Ave, Portland, OR 97210 Phone: 503-413-7260 | |
Dr. Ross Emery Bryan Iv, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 3181 Sw Sam Jackson Park Rd, Ohsu Dept Of Emergency Medicine Cdw-em, Portland, OR 97239 Phone: 503-494-1270 |