Individual
DR. JAMES WILLIAM WATKINS IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2511 NW MILDRED ST, PORTLAND, OR 97210-3336
(503) 295-9545
Mailing address
2511 NW MILDRED ST, PORTLAND, OR 97210-3336
(503) 295-9545
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD00048178
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8485781
—
WA
01
—
GAB32999
MEDICARE GROUP
WA
Enumeration date
09/25/2007
Last updated
01/11/2008
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