Kellie Young, | |
1130 Nw 22nd Ave Ste 410, Portland, OR 97210-2911 | |
(503) 229-7137 | |
Not Available |
Full Name | Kellie Young |
---|---|
Gender | Female |
Speciality | Gastroenterology |
Experience | 9 Years |
Location | 1130 Nw 22nd Ave Ste 410, Portland, Oregon |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1073908588 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0100X | Internal Medicine - Gastroenterology | MD186857 (Oregon) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Legacy Good Samaritan Medical Center | Portland, OR | Hospital |
Legacy Emanuel Medical Center | Portland, OR | Hospital |
Ohsu Hospital And Clinics | Portland, OR | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Northwest Gastroenterology Clinic Llc | 7315935897 | 11 |
Entity Name | Northwest Gastroenterology Clinic Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1407933872 PECOS PAC ID: 7315935897 Enrollment ID: O20040504000352 |
Mailing Address | Practice Location Address |
---|---|
Kellie Young, 1130 Nw 22nd Ave Ste 410, Portland, OR 97210-2911 Ph: () - | Kellie Young, 1130 Nw 22nd Ave Ste 410, Portland, OR 97210-2911 Ph: (503) 229-7137 |
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