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Individual

ANDREW JACOB MICHAELS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
501 N GRAHAM, SUITE 580, PORTLAND, OR 97227
(503) 528-0704
(503) 528-0708
Mailing address
501 N GRAHAM, SUITE 580, PORTLAND, OR 97227
(503) 528-0704
(503) 528-0708

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD20926
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
151145
OR
Enumeration date
01/25/2006
Last updated
07/08/2007
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