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EAST PORTLAND EAR NOSE AND THROAT CLINIC NPI 1730257940


NPI Information

NPI: 1730257940
Provider Name: EAST PORTLAND EAR NOSE AND THROAT CLINIC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
24076 SE STARK ST
SUITE 230
GRESHAM, OR
ZIP 97030
Phone: (503) 465-5461
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EAST PORTLAND EAR NOSE AND THROAT CLINIC is a specialist in Gresham, OR. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. EAST PORTLAND EAR NOSE AND THROAT CLINIC NPI is 1730257940. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

24076 SE STARK ST
SUITE 230
GRESHAM, OR
ZIP 97030-373
Phone: (503) 465-5461
Fax: (503) 465-5468

The provider's authorized official is Roger J Wobig .
The authorized official title is Partner and has the following contact phone number (503) 465-5461.

The enumeration date for this NPI number is 12/4/2006 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistOREGONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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