Provider Demographics
NPI:1215226014
Name:DOWNES, KENNETH MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:MICHAEL
Last Name:DOWNES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3375 SW TERWILLIGER BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-4146
Mailing Address - Country:US
Mailing Address - Phone:503-494-3929
Mailing Address - Fax:
Practice Address - Street 1:7110 WYOMING BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4867
Practice Address - Country:US
Practice Address - Phone:505-346-0500
Practice Address - Fax:505-346-0164
Is Sole Proprietor?:No
Enumeration Date:2011-04-01
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA123717207W00000X
ORMD176549207W00000X
NMMD2017-0187207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology