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Organization
WILLAMETTE VALLEY IMMUNOLOGY CENTER PC
Active
Organization
WILLAMETTE VALLEY IMMUNOLOGY CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS JEFFERSON SADDORIS II M.D. (PHYSICIAN OWNER)
(503) 262-7273
Entity
Organization
Contact information
Practice address
169 NE 102ND AVE, PORTLAND, OR 97220-4169
(503) 262-7273
(503) 262-7274
Mailing address
169 NE 102ND AVE, PORTLAND, OR 97220-4169
(503) 262-7273
(503) 262-7274
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD10197
OR
Other
Enumeration date
06/17/2010
Last updated
06/17/2010
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