Organization
INTERNAL MEDICINE OF OREGON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PORFIRIO PENA JR. MD (OWNER)
(503) 230-9224
Entity
Organization
Contact information
Practice address
5050 NE HOYT ST, SUITE 203, PORTLAND, OR 97213-2991
(503) 230-9224
(503) 230-9201
Mailing address
5050 NE HOYT ST, SUITE 203, PORTLAND, OR 97213-2991
(503) 230-9224
(503) 230-9201
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD15289
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000810
—
OR
Enumeration date
09/24/2007
Last updated
11/26/2007
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