Individual
DR. KENNETH CHARLES GOLDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
407 NE 12TH AVE, STE 200, PORTLAND, OR 97232
(503) 280-0880
(503) 232-7440
Mailing address
407 NE 12TH AVE, STE 200, PORTLAND, OR 97232
(503) 280-0880
(503) 232-7440
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
MD16086
OR
Other
Enumeration date
09/22/2010
Last updated
09/22/2010
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