Individual
DR. CHARLES L. WALTEMATH I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7130 SW SYLVAN CT, PORTLAND, OR 97225-3740
(503) 292-8152
Mailing address
7130 SW SYLVAN CT, PORTLAND, OR 97225-3740
(503) 292-8152
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
MD07724
OR
Other
Enumeration date
04/04/2014
Last updated
04/04/2014
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