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Individual

EDWARD CHAPLAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
839 NE HOLLADAY ST, PORTLAND, OR 97232-3521
(503) 203-0700
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD00045134
WA
207Q00000X
Family Medicine Physician
Primary
MD25602
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500618677
OR
01
P01064947
RR MEDICARE - PH&S - OREGON (PMG)
OR
Enumeration date
07/14/2006
Last updated
10/19/2020
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