Individual
BETHANY JOHANNA COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8211
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8211
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD188034
OR
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD188034
OR
207RP1001X
Pulmonary Disease Physician
Primary
MD188034
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2017
Last updated
06/29/2023
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