Individual
MICHAEL PATRICK COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
11385 SW SCHOLLS FERRY RD, BEAVERTON, OR 97008-7167
(503) 524-9040
Mailing address
13543 SW 64TH AVE, PORTLAND, OR 97219-8054
(503) 349-2710
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
6501
OR
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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