Individual
JOSEPH J MANDIBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5050 NE HOYT ST, SUITE 640, PORTLAND, OR 97213-2991
(503) 231-1426
(503) 231-0316
Mailing address
5050 NE HOYT ST, SUITE 640, PORTLAND, OR 97213-2991
(503) 231-1426
(503) 231-0316
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD 11260
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
244731
—
OR
Enumeration date
09/09/2005
Last updated
09/17/2013
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