Organization
OREGON HEALTH & SCIENCE UNIVERSITY
Active
Other names
OHSU Russell Street Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOE E ROBERTSON M.D. (PRESIDENT)
(503) 494-8252
Entity
Organization
Contact information
Practice address
214 N RUSSELL ST, PORTLAND, OR 97227-1620
(503) 494-6822
(503) 284-1398
Mailing address
214 N RUSSELL ST, PORTLAND, OR 97227-1620
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023965
—
OR
Enumeration date
12/27/2006
Last updated
08/22/2020
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