Individual
DONALD L MULCONREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9155 SW BARNES RD STE 210, PORTLAND, OR 97225-6629
(503) 546-3503
(503) 546-3507
Mailing address
9155 SW BARNES RD STE 210, PORTLAND, OR 97225-6629
(503) 546-3503
(503) 546-3507
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
PA01224
OR
Other
Enumeration date
05/18/2007
Last updated
01/25/2008
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