DR. KENNETH RICHARDS STEVENS JR. (NPI# 1033303847) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033303847 |
| Entity Type | Individual |
| Full Name | DR. KENNETH RICHARDS STEVENS JR. |
| Credential | M.D. |
| Practice Address |
3181 Sw Sam Jackson Park Rd. Kpv4, Radiation Medicine Portland OR 97239-3098 |
| Practice Telephone | 5034948756 |
| Practice Fax Number | 5033460237 |
| Mailing Telephone | 5034948756 |
| Mailing Fax Number | 5033460237 |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2007-09-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
MD07059 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 048913 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184643629 | Kenneth Stevens | Internal Medicine | 3231 S Higuera St, San Luis Obispo, CA 93401-6924 | 2006-07-18 |
| 1053854687 | Kenneth Stevens | Counselor | 102 W Main St, San Jacinto, CA 92583-4121 | 2016-11-30 |
| 1134569882 | Kenneth R Stevens IIi | Internal Medicine | 4077 Fifth Ave # Mer35, San Diego, CA 92103 | 2013-06-26 |
| 1114131315 | Kenneth Troy Stevens | Dentist | 815 N 6th E, Mountain Home, ID 83647-2207 | 2007-05-09 |
| 1184607087 | Kenneth A Stevens | Internal Medicine | 26 Julio Dr, Shrewsbury, MA 01545-3020 | 2005-11-23 |
| Street Address |
3181 SW SAM JACKSON PARK RD. KPV4, RADIATION MEDICINE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97239-3098 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487686994 | Eugene Lloyd Hiebert | Anesthesiology | 3181 Sw Sam Jackson Park Rd., Portland, OR 97239-3011 | 2006-07-07 |
| 1144856170 | Kimberley Adaire Bullard | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd., Portland, OR 97239 | 2020-03-21 |
| 1821521279 | Bruce Leewiwatanakul | Pediatrics | 3181 Sw Sam Jackson Park Rd., Ohsu, Portland, OR 97239 | 2017-04-04 |
| 1871947473 | Claire Fraley | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd., Ohsu, Portland, OR 97239 | 2016-04-20 |
| 1023472149 | Poone Shoureshi | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd., Ohsu, Portland, OR 97239 | 2016-04-06 |
| 1780079459 | Aaron Todd Smith | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd., L-579, Portland, OR 97239 | 2015-03-31 |
| 1639597941 | Asha Jetmalani | Psychiatry & Neurology | 3181 Sw Sam Jackson Park Rd., Ohsu, Portland, OR 97239 | 2014-04-03 |
| 1457779233 | Raphael Micah Byrne | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd., Ohsu, Portland, OR 97239 | 2014-03-31 |
| 1316387251 | Amber Faast | Radiology | 3181 Sw Sam Jackson Park Rd., Portland, OR 97239-3011 | 2013-06-25 |
| 1972949253 | Gurion Seth Lantz | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3181 Sw Sam Jackson Park Rd., Mail Code L353, Portland, OR 97239 | 2013-05-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558979468 | Elise Caitlin Esposito | Student in an Organized Health Care Education/Training Program | 3710 Sw U.S. Veterans Hospital Road, Dental Service P-3 Dent, Attn: Elise Esposito, Portland, OR 97239 | 2020-07-16 |
| 1750908844 | Will Cowan | Student in an Organized Health Care Education/Training Program | 455 Sw Us Veterans Hospital Road., Portland, OR 97239 | 2020-07-06 |
| 1881219657 | Desiree Baer | Licensed Vocational Nurse | Sw Us Veterans Hospital Rd, Portland, OR 97239 | 2020-06-08 |
| 1285266205 | Melissa Irene Wheeler | Registered Nurse | Uhs-8l, 3181 S.w. Sam Jackson Park Road, Portland, OR 97239 | 2020-02-07 |
| 1225687981 | Pheba Mariam Jones | Pharmacist | Ohsu Pharmacy At Chh Building 2, 3303 Sw Bond Ave Rm 1090, Portland, OR 97239 | 2019-09-05 |
| 1801448063 | Alice Huang Huang | Student in an Organized Health Care Education/Training Program | 3710 Sw Veterans Road, Portland, OR 97239 | 2019-07-09 |
| 1710446273 | Ellen Noreen Kessi | Social Worker | 3710 Sw Us Veterans Rd., Portland, OR 97239 | 2019-03-14 |
| 1508335704 | Jacqueline Marie Mular | Marriage & Family Therapist | 5550 Sw Macadam Suite 100, Portland, OR 97239 | 2018-11-16 |
| 1275030926 | Carly Elizabeth Dougher | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd., Portland, OR 97239 | 2018-04-10 |
| 1780188094 | Dennis John Samuel | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd. L-579, Portland, OR 97239 | 2018-03-21 |
| Find all providers in zip 97239 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235549031 | Amar Srivastava | Radiology | 4805 Ne Glisan St, Garden Level, Portland, OR 97213 | 2014-05-01 |
| 1962848655 | Joshua M Walker | Radiology | 3181 Sw Sam Jackson Park Rd # Kpv4, Portland, OR 97239 | 2013-05-21 |
| 1578610382 | Jerry Jeff Jaboin | Radiology | 3181 Sw Sam Jackson Park Rd # L337, Department of Radiation Medicine, Portland, OR 97239-3011 | 2007-01-04 |
| 1770520892 | Katie Anne Deming | Radiology | 1400 Nw Irving St, 527, Portland, OR 97209-2210 | 2006-05-31 |
| 1043299217 | Andrew Yoo Jong Kee | Radiology | 1130 Nw 22nd Ave Ste Ll50, Portland, OR 97210-2900 | 2006-01-16 |
| 1083601835 | Thomas Harry Johnson | Radiology | 3620 N Interstate Ave, Portland, OR 97227-1106 | 2005-10-05 |
| 1356338149 | Misa Melissa Lee | Radiology | 1130 Nw 22nd Avenue, Ll50, Portland, OR 97210-2900 | 2005-10-05 |
| 1952780512 | Blair M Murphy | Radiology | 3181 Sw Sam Jackson Park Rd # Kpv4, Portland, OR 97239-3011 | 2015-05-28 |
| 1114304870 | Eric Michael Chang | Radiology | 3181 Sw Sam Jackson Park Rd # L337, Portland, OR 97239-3011 | 2015-05-01 |
| 1073908505 | Whitney Beeler | Radiology | 22 Bramhall St, Portland, ME 04102-3134 | 2015-04-01 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.