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Contact Information

MARK A PETROFF, MD
17720 JEAN WAY
SUITE100
LAKE OSWEGO, OR97035-5394
 Phone: 503-635-4886
 Fax: 503-635-1655
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery Within the Head and Neck

2082S0099X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for MARK A PETROFF · (Male)

NPI # 1528068129
Status Active
Credentials MD
Entity Individual
Enumeration date 07/26/2005
Last updated 03/07/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • OR License # MD15996
  • OR Medicaid 069609
  • OR Other MD15996 STATE LICENSE
Hospital affiliation(s) Not Available
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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