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Individual

BIRCH A PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5 CENTERPOINTE DR, LAKE OSWEGO, OR 97035-8651
(800) 718-1259
Mailing address
5 CENTERPOINTE DR, LAKE OSWEGO, OR 97035-8651
(800) 718-1259

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD19151
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00200694
RR MEDICARE
OR
Enumeration date
07/12/2006
Last updated
09/23/2015
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