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Individual

LOUIS THEODORE COHEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
10150 SE 32ND AVE, MILWAUKIE, OR 97222-6516
(503) 513-8695
(503) 513-8866
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
DO26598
OR
208M00000X
Hospitalist Physician
Primary
DO26598
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006014
OR
01
P00424829
RR MEDICARE (PH&S)-PMG
OR
Enumeration date
06/07/2006
Last updated
11/29/2021
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