Individual
DR. MARK LEO MCKINSTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19875 SW 65TH AVE, TUALATIN, OR 97062-8353
(503) 692-7785
(503) 885-1663
Mailing address
19875 SW 65TH AVE, TUALATIN, OR 97062-8353
(503) 692-7785
(503) 885-1663
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16271
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028063
—
OR
Enumeration date
03/17/2006
Last updated
02/25/2011
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