Organization
COLUMBIA SURGICAL SPECIALISTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERNON L COWELL, JR M.D. (OWNER)
(503) 667-4000
Entity
Organization
Contact information
Practice address
25500 SE STARK ST STE 101, GRESHAM, OR 97030-8327
(503) 667-4000
(503) 661-0835
Mailing address
25500 SE STARK ST STE 101, GRESHAM, OR 97030-8327
(503) 667-4000
(503) 661-0835
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD20828
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150464
—
OR
Enumeration date
07/16/2006
Last updated
11/08/2007
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