Individual
SETH DAVID IZENBERG
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 N GRAHAM, SUITE #580, PORTLAND, OR 97227
(503) 528-0704
(503) 528-0708
Mailing address
501 N GRAHAM, SUITE #580, PORTLAND, OR 97227
(503) 528-0704
(503) 528-0708
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
00015457
AL
208600000X
Surgery Physician
014019
TX
208600000X
Surgery Physician
Primary
MD21051
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287738
—
OR
Enumeration date
01/24/2006
Last updated
07/08/2007
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