Baltrusch, Kyle Matthew
Baltrusch, Kyle Matthew is an individual health care provider with primary practice located at 1200 Nw Naito Pkwy Ste 310 , Portland OR 97209-2829. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Baltrusch, Kyle Matthew can be contacted via phone (503) 292-9200.Contact Information
Primary practice address
1200 Nw Naito Pkwy Ste 310
Portland OR 97209-2829
Phone: (503) 292-9200
Fax: (503) 292-9205
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery | 2086S0122X | MD205639 | Oregon |
Profile Details
| NPI number | 1952741779 |
|---|---|
| LBN Legal business name | Baltrusch, Kyle Matthew |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 25th, 2013 |
| Last updated | Jul 19th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952741779 | NPPES |
| Oregon | MEDICAID | 500688755 |
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