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Contact Information

PETER K BLACK, MD
8716 E MILL PLAIN BLVD
VANCOUVER, WA98664-2531
 Phone: 360-514-4325
 Fax: 360-514-4336
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Undersea and Hyperbaric Medicine

2083P0011X 84 Physician/Preventive Medicine
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for PETER K BLACK · (Male)

NPI Number 1265460406
Status Active
Credentials MD
Entity Individual
Enumeration date 06/28/2006
Last updated 06/26/2025 - About 11 months ago
Sole proprietor 1 No
Identifiers
  • OR License # MD24481
  • WA License # MD61439872
  • OR Medicaid 227426
  • OR Other P00464800 RR MEDICARE
Hospital affiliation(s)
  • PROVIDENCE PORTLAND MEDICAL CENTER - (Acute Care)
    4805 NE GLISAN STREET
    PORTLAND, OR 97213
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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