Kaufman Medical Group, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

DO08427 Issued in OR

Legal business name

KAUFMAN MEDICAL GROUP, LLC

Practice address

1750 Blankenship Rd Ste 275
West Linn, OR 97068-5101

Phone

(503) 657-0074

Fax

(503) 657-0295

NPI assigned

Apr 21, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Evan McKechnie

Title

Office Manager

Phone

(503) 657-0074

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208736000000",
    "number": "1154595114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 BLANKENSHIP RD STE 275",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970685101",
            "telephone_number": "503-657-0074",
            "fax_number": "503-657-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 BLANKENSHIP RD STE 275",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970685101",
            "telephone_number": "503-657-0074",
            "fax_number": "503-657-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAUFMAN MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-21",
        "last_updated": "2008-04-21",
        "status": "A",
        "authorized_official_last_name": "MCKECHNIE",
        "authorized_official_first_name": "EVAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "503-657-0074",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "DO08427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C91767",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Guinevere Zandt Jones, LMT
• Mikki Jordan, LCSW
• Adrian Leslie Kalil, CRNA CERTIFIFED REGI
• Karl O. Wustrack,MD,PC
• Cynthia Katancik
• Steven R Kaufman, DO
• Daralyn Kawamoto, PHARMD
• Shayla Marie Keegan, LMT
• Heather Keeler, D.P.M
• Jason A. Keeler, DPM

• Pediatrics Physician in West Linn, OR
• Providers in West Linn, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.