Individual
HENRY W VEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1015 NW 22ND AVE, PORTLAND, OR 97210-3025
(503) 413-7127
(503) 227-0218
Mailing address
PO BOX 3730, #DINW103, PORTLAND, OR 97208-3730
(800) 878-6698
(918) 665-4180
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD14485
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028036008
BCBS REGENCE
OR
05
—
204156
—
OR
01
—
300101079
RR MEDICARE
OR
05
—
4118139
—
CA
05
—
8578502
—
WA
05
—
MD5546R
—
AK
Enumeration date
06/07/2006
Last updated
11/10/2011
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