Individual
DR. JAMES A PEYKANU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5251 NE GLISAN ST, 2ND FLOOR, PORTLAND, OR 97213-3052
(503) 215-4860
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD150292
OR
2084F0202X
Forensic Psychiatry Physician
MD150292
OR
2084P0015X
Psychosomatic Medicine Physician
MD150292
OR
2084P0800X
Psychiatry Physician
22332
WV
2084P0800X
Psychiatry Physician
Primary
MD150292
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810012435
—
WV
05
—
500636385
—
OR
05
—
5006367411
—
OR
01
—
P00631474
RAILROAD MEDICARE PART B
WV
Enumeration date
05/29/2007
Last updated
08/27/2013
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