Individual
DR. ROBERT BRIAN BETTENCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11782 SW BARNES RD STE 300, PORTLAND, OR 97225-5933
(503) 214-5200
(503) 906-6613
Mailing address
11782 SW BARNES RD STE 300, PORTLAND, OR 97225-5933
(503) 214-5200
(503) 906-6613
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
29467
AL
207Q00000X
Family Medicine Physician
Primary
MD157616
OR
207Q00000X
Family Medicine Physician
NONE
AL
207QS0010X
Sports Medicine (Family Medicine) Physician
29467
AL
207QS0010X
Sports Medicine (Family Medicine) Physician
MD157616
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5006514641
—
OR
01
—
MD157616
OREGON MEDICAL LICENSE
OR
Enumeration date
03/11/2008
Last updated
06/03/2021
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