Provider Demographics
NPI:1629364963
Name:MILONAS, KEENAN ANTHONY (MD)
Entity type:Individual
Prefix:
First Name:KEENAN
Middle Name:ANTHONY
Last Name:MILONAS
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 1:2207 N MOLTER RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-7571
Mailing Address - Country:US
Mailing Address - Phone:509-241-3541
Mailing Address - Fax:509-505-6301
Practice Address - Street 1:2207 N MOLTER RD STE 100
Practice Address - Street 2:
Practice Address - City:LIBERTY LAKE
Practice Address - State:WA
Practice Address - Zip Code:99019-7571
Practice Address - Country:US
Practice Address - Phone:509-241-3541
Practice Address - Fax:509-505-6301
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-24
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60404319207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine