# MARK A TERRY MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972637528
- **Authorized official:** MARK A TERRY MD (PRESIDENT)
- **Authorized official phone:** (503) 413-6467

## Contact information

- **Practice address:** 1040 NW 22ND AVE, \#200, PORTLAND, OR 97210
- **Practice address phone:** (503) 413-8202
- **Practice address fax:** (503) 413-6937
- **Mailing address:** 1040 NW 22ND AVE, \#200, PORTLAND, OR 97210
- **Mailing address phone:** (503) 413-8202
- **Mailing address fax:** (503) 413-6937

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/15/2007
- **Last updated:** 12/26/2012