Individual
JUAN C IREGUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6350 NE HALSEY ST, PORTLAND, OR 97213-4720
(503) 215-2669
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME0089146
FL
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
MD00046468
WA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
MD209288
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0210626
STATE L&I
WA
01
—
0240615
STATE L&I
WA
05
—
271170200
—
FL
05
—
8457285
—
WA
01
—
8941690
STATE CRIME VICTIMS
WA
01
—
8948910
STATE CRIME VICTIMS
WA
Enumeration date
05/16/2006
Last updated
02/10/2023
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