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NPI Profile for PROVIDENCE HEALTH SERVICES OREGON in PORTLAND, OR.
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Hematology & Oncology |
207RH0003X | 11 | Physician/Internal Medicine | |
Clinic/Center |
261Q00000X | |||
Hepatology |
207RI0008X | 11 | Physician/Internal Medicine | |
Medical Oncology |
207RX0202X | 11 | Physician/Internal Medicine | |
Surgery |
208600000X | 02 | Physician/General Surgery | |
Surgical Oncology |
2086X0206X | 02 | Physician/General Surgery |
| NPI Number | 1801010004 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 04/12/2007 | |
| Last updated | 07/04/2025 - About 11 months ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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PROVIDENCE HEALTH & SERVICES OREGON
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PROVIDENCE HEALTH & SERVICES OREGON