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Individual

DR. CASEY ELIZABETH FERGUSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4805 NE GLISAN ST, STE BG05, PORTLAND, OR 97213-2933
(503) 215-2392
Mailing address
1027 E BURNSIDE ST, PORTLAND, OR 97214-1328
(503) 239-8400

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD27372
OR
207RA0401X
Addiction Medicine (Internal Medicine) Physician
MD27372
OR
208M00000X
Hospitalist Physician
MD27372
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
243094
OR
05
92075355
NM
01
P00464817
RAILROAD MEDICARE - PROVIDENCE
OR
Enumeration date
03/20/2007
Last updated
05/18/2023
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