Individual
MR. STOTZ THODA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4104 SE 82ND AVE, SUITE 250, PORTLAND, OR 97266-2954
(503) 215-9850
Mailing address
600 SW COLUMBIA ST, STE 6210, BEND, OR 97702-1099
(541) 323-3181
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO185779
OR
207Q00000X
Family Medicine Physician
PG173375
OR
Other
Enumeration date
07/16/2014
Last updated
09/19/2019
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