Provider Demographics
NPI:1922295583
Name:SLICHO, KEITH TURNER (DO)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:TURNER
Last Name:SLICHO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:700 NE MULTNOMAH ST
Mailing Address - Street 2:STE. 330
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2131
Mailing Address - Country:US
Mailing Address - Phone:503-208-7032
Mailing Address - Fax:503-208-7034
Practice Address - Street 1:700 NE MULTNOMAH ST
Practice Address - Street 2:STE. 330
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2131
Practice Address - Country:US
Practice Address - Phone:503-208-7032
Practice Address - Fax:503-208-7034
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2016-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORDO158686204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K4175Medicare PIN