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Individual

ROBERT L WELLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5050 NE HOYT ST, SUITE 240, PORTLAND, OR 97213-2991
(503) 215-6480
(503) 215-6469
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD13215
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
276824
OR
01
80054839
RR MEDICARE
OR
Enumeration date
07/08/2006
Last updated
03/25/2021
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