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Contact Information

JOHN MCANULTY
1040 NW 22ND AVE, SUITE 660
PORTLAND, OR97210
 Phone: 503-413-7162
 Fax: 503-413-7148
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Clinical Cardiac Electrophysiology

207RC0001X 11 Physician/Internal Medicine
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for JOHN MCANULTY · (Male)

NPI # 1518993492
Status Active
Credentials
Entity Individual
Enumeration date 06/23/2006
Last updated 06/10/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • OR License # 9170
  • OR License # MD09170
  • OR Medicaid 125849
Hospital affiliation(s)
  • LEGACY EMANUEL MEDICAL CENTER - (Acute Care)
    2801 N GANTENBEIN AVENUE
    PORTLAND, OR 97227
  • LEGACY GOOD SAMARITAN MEDICAL CENTER - (Acute Care)
    1015 NW 22ND AVENUE, W121
    PORTLAND, OR 97210
  • LEGACY MOUNT HOOD MEDICAL CENTER - (Acute Care)
    24800 SE STARK STREET
    GRESHAM, OR 97030
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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