Individual
DR. ANDREW DALE PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5050 NE HOYT ST, SUITE 655, PORTLAND, OR 97213-2991
(503) 488-2400
(503) 231-0121
Mailing address
541 NE 20TH AVE STE 225, PORTLAND, OR 97232-2895
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD19567
OR
207Y00000X
Otolaryngology Physician
MD60381043
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080320
—
OR
05
—
8448896
—
WA
Enumeration date
02/22/2006
Last updated
11/04/2024
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