Unknown Individual – Surgery Physician, NPI 1619977063
Surgery Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
3777, Southeast Naef Road, Concord, Portland, Metro, Clackamas County, Oregon, 97267, United States
PORTLAND, OR 972083777
Phone: (503) 413-5725
Fax: (503) 413-5726
Type: Mailing
1130, Northwest 22nd Avenue, Northwest District, Portland, Metro, Multnomah County, Oregon, 97210, United States
SUITE #420
PORTLAND, OR 972102900
Phone: (503) 413-5725
Fax: (503) 413-5726
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97208)
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