Individual
WALTER L STANDRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10180 SE SUNNYSIDE RD, WING A, CLACKAMAS, OR 97015-8970
(503) 571-0892
(503) 571-0867
Mailing address
10180 SE SUNNYSIDE RD, WING A, CLACKAMAS, OR 97015-8970
(503) 571-0892
(503) 571-0867
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
32903
CO
208M00000X
Hospitalist Physician
32903
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12300063
—
CO
Enumeration date
08/14/2006
Last updated
05/22/2025
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