Active NPI
Keith H Swenson, MD
- Dermatology Physician
- Portland, OR
National Provider Identifier
1679599757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- MD08981
- Practice address
- 5050 NE Hoyt St
Suite 454
Portland, OR 97213-2991 - Phone
- (503) 215-6405
- Fax
- (503) 215-6429
- NPI assigned
- Jul 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | MD08981 | OR | Primary |
Addresses
Primary practice location
5050 NE Hoyt St
Suite 454
Portland, OR 97213-2991
Mailing address
PO Box 13994
Portland, OR 97213-0994
Phone (503) 215-6494
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110058129 | Other | OR | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD08981 | OR | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213574400000",
"number": "1679599757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 13994",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972130994",
"telephone_number": "503-215-6494",
"fax_number": "503-215-6644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5050 NE HOYT ST",
"address_2": "SUITE 454",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972132991",
"telephone_number": "503-215-6405",
"fax_number": "503-215-6429"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWENSON",
"first_name": "KEITH",
"middle_name": "H",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-14",
"last_updated": "2008-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "OR",
"license": "MD08981",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "110058129",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.