Individual
DR. DANIEL J CONSTIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 380-4319
Mailing address
PO BOX 927, GRESHAM, OR 97030-0207
(503) 380-4319
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16407
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004403
—
OR
Enumeration date
05/19/2006
Last updated
07/08/2007
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