Individual
JUSTIN EVANS DENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8573
Mailing address
5739 SW CHELTENHAM DR, PORTLAND, OR 97239-2776
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD21967
OR
Other
Enumeration date
10/09/2006
Last updated
07/08/2007
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