Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Apr 3, 2017
License(s)
314838 (NY), MD227220 (OR)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 10180 SE SUNNYSIDE RD | Clackamas, OR 97015-8970 | 800-813-2000 |
| MAILING | 500 NE MULTNOMAH ST STE 100 | Portland, OR 97232-2031 |
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