Individual
DR. MARTIN ATHELSTAN BAGGENSTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9155 SW BARNES RD STE 440, PORTLAND, OR 97225-6631
(503) 935-8500
(503) 935-8505
Mailing address
541 NE 20TH AVE STE 225, PORTLAND, OR 97232-2895
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MD153961
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114153194
—
WA
05
—
500635997
—
OR
Enumeration date
06/04/2009
Last updated
11/22/2023
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