Individual
CHARLES A HENRIKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, DIVISION OF CARDIOLOGY UHN 62, PORTLAND, OR 97239-3011
(503) 494-8750
(503) 494-8550
Mailing address
3181 SW SAM JACKSON PARK RD, DIVISION OF CARDIOLOGY UHN 62, PORTLAND, OR 97239-3011
(503) 494-8750
(503) 494-8550
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
D0056584
MD
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
MD155423
OR
Other
Enumeration date
03/27/2006
Last updated
09/16/2011
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