Individual
DR. CHARLES BARRY GOLDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7215 SE 13TH AVE, PORTLAND, OR 97202
(503) 954-2187
(503) 238-7025
Mailing address
7215 SE 13TH AVE, PORTLAND, OR 97202-5803
(503) 954-2187
(503) 238-7025
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD11101
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268490
—
OR
Enumeration date
05/02/2006
Last updated
05/24/2019
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