Individual
KARL STOLTZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2800 N VANCOUVER AVE STE 230, LEGACY CLINIC EMANUEL, PORTLAND, OR 97227-1668
(503) 413-4340
(503) 413-4898
Mailing address
2800 N VANCOUVER AVE STE 230, PORTLAND, OR 97227-1668
(505) 718-5232
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD2019-0293
NM
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/01/2016
Last updated
07/03/2019
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