Individual
MARK D LIVINGSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1015 NW 22ND AVE, PORTLAND, OR 97210-3025
(503) 413-7260
Mailing address
6312 SW CAPITOL HWY # 502, PORTLAND, OR 97239-1938
(503) 464-9034
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD20675
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130113
—
OR
Enumeration date
07/26/2006
Last updated
07/08/2007
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