Individual
DR. FREDERICK ANTHONY TIBAYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, MAIL CODE: L353, PORTLAND, OR 97239-3011
(503) 494-7820
Mailing address
3181 SW SAM JACKSON PARK RD, MAIL CODE: L353, PORTLAND, OR 97239-3011
(503) 494-7820
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
A77336
CA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD126341
OR
Other
Enumeration date
09/18/2007
Last updated
01/07/2013
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