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NPI Profile for REVIANCE PORTLAND LLC in CLACKAMAS, OR.
A plastic surgeon with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgery is practiced, there are many additional procedures which interface with them.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Plastic Surgery Within the Head and Neck |
2082S0099X | 02 | Physician/General Surgery |
| NPI Number | 1497474993 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 08/26/2022 | |
| Last updated | 08/26/2022 - About 4 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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REVIANCE PORTLAND, LLC
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REVIANCE PORTLAND, LLC