Provider Demographics
NPI:1831247147
Name:STRAUSS, WILLIAM STEVEN KENT (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:STEVEN KENT
Last Name:STRAUSS
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:P.O. BOX 5236
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304
Mailing Address - Country:US
Mailing Address - Phone:503-585-0830
Mailing Address - Fax:503-585-4523
Practice Address - Street 1:890 OAK ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301
Practice Address - Country:US
Practice Address - Phone:503-585-0830
Practice Address - Fax:503-585-4523
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD15029174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR116673Medicaid
ORC91919Medicare UPIN
OR116673Medicaid
OR0000BHVXLMedicare ID - Type UnspecifiedMEDICARE