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Individual

DR. CLIFFORD JOE ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
233 NW 16TH AVE, PORTLAND, OR 97209-2630
(503) 223-6480
(503) 294-1868
Mailing address
233 NW 16TH AVE, PORTLAND, OR 97209-2630
(503) 297-4779

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
MD00019556
WA
207K00000X
Allergy & Immunology Physician
Primary
MD09504
OR
207KA0200X
Allergy Physician
MD00019556
WA
207KA0200X
Allergy Physician
MD09504
OR
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
MD00019556
WA
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
MD09504
OR
207RR0500X
Rheumatology Physician
MD09504
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004028
OR
Enumeration date
06/22/2005
Last updated
08/22/2008
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