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Individual

DR. SIDNEY J PRESCOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
700 NE MULTNOMAH ST, SUITE 1600, PORTLAND, OR 97232-2131
(503) 249-5454
(503) 249-5498
Mailing address
7650 SW BEVELAND RD, SUITE 200, PORTLAND, OR 97223-8692
(503) 249-5454
(503) 249-5498

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD13260
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
277491
OR
01
R184666
MEDICARE PTAN
OR
Enumeration date
09/16/2005
Last updated
06/22/2017
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