Individual
CODY MACMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 813-2000
Mailing address
5014 NE 36TH AVE, PORTLAND, OR 97211-7624
(541) 300-0262
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD190214
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2013
Last updated
02/04/2022
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