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Organization
GEORGE M DOUGLASS MD PC
Active
Organization
GEORGE M DOUGLASS MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE M DOUGLASS JR. MD (OWNER)
(503) 502-3989
Entity
Organization
Contact information
Practice address
9445 SW LOCUST ST, TIGARD, OR 97223-6634
(503) 352-1313
(503) 352-1314
Mailing address
9445 SW LOCUST ST, TIGARD, OR 97223-6634
(503) 352-1313
(503) 352-1314
Taxonomy
Speciality
Code
Description
License number
State
207PS0010X
Sports Medicine (Emergency Medicine) Physician
Primary
MD22100
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
240052
—
OR
Enumeration date
02/01/2013
Last updated
02/01/2013
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