Individual
DR. GEORGE M DOUGLASS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17355 BOONES FERRY RD, SUITE C, LAKE OSWEGO, OR 97035-5202
(503) 344-6445
(503) 344-6852
Mailing address
17355 BOONES FERRY RD, SUITE C, LAKE OSWEGO, OR 97035-5202
(503) 344-6445
(503) 344-6852
Taxonomy
Speciality
Code
Description
License number
State
207PS0010X
Sports Medicine (Emergency Medicine) Physician
Primary
MD22100
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
210868
WA L & I
—
05
—
240052
—
OR
05
—
8244444
—
WA
01
—
8942008
WA CRIME VICTIMS
—
01
—
P00350187
RAILROAD MEDICARE
—
Enumeration date
06/13/2006
Last updated
12/03/2018
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