Provider Demographics
NPI:1508865015
Name:KAHN, KAREN TRESSER (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:TRESSER
Last Name:KAHN
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 1:625 STEVENS ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-6719
Mailing Address - Country:US
Mailing Address - Phone:541-646-2242
Mailing Address - Fax:541-488-4081
Practice Address - Street 1:625 STEVENS ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6719
Practice Address - Country:US
Practice Address - Phone:541-646-2242
Practice Address - Fax:541-488-4081
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD19081207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR227698Medicaid
OR08WCJDRBMedicare ID - Type Unspecified
ORE90611Medicare UPIN