Provider Demographics
NPI:1871797654
Name:KEAN, BRET THOMAS (MD)
Entity type:Individual
Prefix:
First Name:BRET
Middle Name:THOMAS
Last Name:KEAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6542 SE LAKE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-2244
Mailing Address - Country:US
Mailing Address - Phone:503-659-1769
Mailing Address - Fax:503-659-7522
Practice Address - Street 1:6542 SE LAKE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-2244
Practice Address - Country:US
Practice Address - Phone:503-659-1769
Practice Address - Fax:503-659-7522
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2010-11-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT6611350-1205207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery