# MARK A. PETROFF, MD. PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Petroff Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275607616
- **Authorized official:** DR. MARK A PETROFF MD (PRESIDENT)
- **Authorized official phone:** (503) 607-1304

## Contact information

- **Practice address:** 17720 JEAN WAY STE 100, LAKE OSWEGO, OR 97035-5575
- **Practice address phone:** (503) 635-4886
- **Practice address fax:** (503) 635-1655
- **Mailing address:** 17720 JEAN WAY STE 100, LAKE OSWEGO, OR 97035-5575
- **Mailing address phone:** (503) 635-4886
- **Mailing address fax:** (503) 635-1655

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 07-1550 | OR | Yes |

## Other

- **Enumeration date:** 11/18/2006
- **Last updated:** 05/07/2008