Individual
JOHN GUY MASTRONARDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 NE 99TH AVE, PORTLAND, OR 97220-9428
(503) 963-3030
(503) 963-3140
Mailing address
847 NE 19TH AVE, SUITE 300, PORTLAND, OR 97232-2684
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
35059362
OH
207RP1001X
Pulmonary Disease Physician
35059362
OH
207RP1001X
Pulmonary Disease Physician
Primary
MD173777
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0786690
—
OH
05
—
129950
—
OR
05
—
2046986
—
WA
Enumeration date
08/17/2006
Last updated
09/21/2015
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