Individual
PETER E GOODKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9775 SE SUNNYSIDE ROAD, SUITE 500, CLACKAMAS, OR 97015-5724
(503) 654-7546
(503) 786-3542
Mailing address
9775 SE SUNNYSIDE ROAD, SUITE 500, CLACKAMAS, OR 97015-5724
(503) 654-7546
(503) 786-3542
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD09756
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
057794
—
OR
Enumeration date
01/10/2006
Last updated
09/24/2010
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