institution
Willamette General & Colon-rectal Surgery Pc
Specialist in Tualatin, Oregon
NPI 1396736518

Willamette General & Colon-rectal Surgery Pc is a Specialist based in Tualatin, OR. Willamette General & Colon-rectal Surgery Pc practices in Tualatin, OR. The NPI Number for Willamette General & Colon-rectal Surgery Pc is 1396736518 and holds a License No. MD20653 (Oregon).

The current practice location address for Willamette General & Colon-rectal Surgery Pc is 19875 Sw 65Th Ave, Tualatin, OR and can be reached out via phone at 503-691-1743 and via fax at 503-691-0983.

Location: 19875 Sw 65Th Ave, Tualatin, OR, 97062-8353
institution
Provider Profile Details
NPI Number
1396736518
Provider Name
Willamette General & Colon-rectal Surgery Pc
Credential
Provider Entity Type
Organization
Address
19875 Sw 65Th Ave, Tualatin, OR, 97062-8353
Phone Number
503-691-1743
Fax Number
503-691-0983
Provider Enumeration Date
11/04/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
R105002 01 OR MEDICARE PTAN
150330 05 OR
1375470 01 OR UNITED HEALTHCARE
000035001 01 OR BLUE CROSS
3007286-01 01 OR MHN
institution
Provider Business Practice Location Address Details
Address
19875 Sw 65Th Ave
City
State
Zip
97062-8353
Phone Number
503-691-1743
Fax Number
503-691-0983
person
Provider Business Mailing Address Details
Address
19875 Sw 65Th Ave
City
State
Zip
97062-8353
Phone Number
503-691-1743
Fax Number
503-691-0983
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
License No.
MD20653 (Oregon)
Definition
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.
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