Individual
MOHAMMAD HISSOUROU III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
808 SW CAMPUS DR, PORTLAND, OR 97239-3008
(503) 494-8756
Mailing address
1900 NW MYHRE RD, SILVERDALE, WA 98383-7662
(564) 240-3100
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD209773
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2018
Last updated
06/06/2023
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