Provider Demographics
NPI:1609048271
Name:KAESCHE, WAYNE (MD)
Entity Type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:
Last Name:KAESCHE
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 1:16001 QUARRY RD
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-3359
Mailing Address - Country:US
Mailing Address - Phone:503-635-1604
Mailing Address - Fax:503-635-6659
Practice Address - Street 1:16001 QUARRY RD
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-3359
Practice Address - Country:US
Practice Address - Phone:503-635-1604
Practice Address - Fax:503-635-6659
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD07359207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery