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Physicians Radiology Radiation Oncology

Provider NPI: 1942362413

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
Tel: 503-251-6305  Fax: 503-251-6802

Business Mailing Address:
PO BOX 3987  PORTLAND, OR 97208-3987 US
Tel: 503-356-9166  Fax: 503-771-7221

NPI Information:
NPI: 1942362413
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Radiation Oncology

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 2085R0001X





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