Provider Demographics
NPI:1437154226
Name:PRICE, KURSTEEN SALTER (MD)
Entity Type:Individual
Prefix:DR
First Name:KURSTEEN
Middle Name:SALTER
Last Name:PRICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9701 SW BARNES RD STE 130
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6688
Mailing Address - Country:US
Mailing Address - Phone:503-297-4779
Mailing Address - Fax:503-297-0499
Practice Address - Street 1:2275 W BURNSIDE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-3541
Practice Address - Country:US
Practice Address - Phone:503-575-7112
Practice Address - Fax:503-206-5016
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00041653207K00000X, 207KA0200X, 207KI0005X
ORMD24108207KA0200X, 207KI0005X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207KI0005XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyClinical & Laboratory Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR286454Medicaid
WAGAB32875Medicare PIN
H69807Medicare UPIN
ORR113966Medicare PIN