Individual
PATRICIO A. RIQUELME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, BTE119, PORTLAND, OR 97239-3011
(503) 494-1164
(503) 494-1159
Mailing address
3181 SW SAM JACKSON PARK RD, BTE119, PORTLAND, OR 97239-3011
(503) 494-1164
(503) 494-1159
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A122559
CA
207R00000X
Internal Medicine Physician
MD167475
OR
208M00000X
Hospitalist Physician
Primary
MD167475
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2011
Last updated
09/25/2015
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