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Individual

DOUGLAS R NIEHUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
12442 SW SCHOLLS FERRY RD, SUITE 100, TIGARD, OR 97223-3396
(503) 216-9200
(503) 216-9220
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD19965
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080142088
RR MEDICARE - PHS
OR
05
080577
OR
Enumeration date
07/04/2006
Last updated
08/27/2015
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