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Individual

DR. WALKER BRYAN DIXON III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1815 SW MARLOW AVE STE 112, PORTLAND, OR 97225-5185
(503) 449-5518
(503) 223-3163
Mailing address
1815 SW MARLOW AVE., SUITE 112, PORTLAND, OR 97225
(503) 449-5518
(503) 223-3163

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD23069
OR
2084P0800X
Psychiatry Physician
Primary
MD23069
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
286961
OR
05
500627051
OR
01
P00924568
RR MEDICARE
OR
Enumeration date
01/25/2007
Last updated
07/21/2022
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