Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 0987 | OR |
Y | 103TC0700X | Clinical Psychologist | 0987 | OR |
NPI | 1003850959 |
---|---|
Provider Name | Thomas F Keefe |
First Address | Eugene, OR 97402-0451 |
Second Address | Eugene, OR 97401-8122 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 02/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
276601 | (05) | OR |
S14511 | (02) |