Provider Demographics
NPI:1740471648
Name:KILLINGBECK, ANNE C (MD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:C
Last Name:KILLINGBECK
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 1:1555 SW REINDEER AVE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-9449
Mailing Address - Country:US
Mailing Address - Phone:541-548-4088
Mailing Address - Fax:541-548-3732
Practice Address - Street 1:1555 SW REINDEER AVE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-9449
Practice Address - Country:US
Practice Address - Phone:541-548-4088
Practice Address - Fax:541-548-3732
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2021-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD152262207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORMD1552262OtherSTATE LICENSE