Individual
KENNETH I MARSHACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6600 NE SANDY BLVD, PORTLAND, OR 97213-5250
(503) 284-4723
(503) 284-5827
Mailing address
20322 NE INTERLACHEN LN, FAIRVIEW, OR 97024-8727
(503) 661-6114
(503) 661-6114
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5268
OR
Other
Enumeration date
09/22/2006
Last updated
07/21/2022
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