Individual
MACAELAN COLLINS HANRAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1850 NE 162ND AVE, PORTLAND, OR 97230-5642
(503) 257-0162
(503) 251-2330
Mailing address
1850 NE 162ND AVE, PORTLAND, OR 97230-5642
(503) 257-0162
(503) 251-2330
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D11653
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D11653
—
OR
Enumeration date
08/01/2022
Last updated
08/01/2022
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