Organization
PORTLAND SURGICAL SPECIALISTS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS R. EUBANKS D.O. (PRESIDENT)
(503) 353-3005
Entity
Organization
Contact information
Practice address
9200 SE 91ST AVE, #320, PORTLAND, OR 97086
(503) 353-3005
(503) 546-3201
Mailing address
9200 SE 91ST AVE, #320, PORTLAND, OR 97086
(503) 353-3005
(503) 546-3201
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278453
—
OR
01
—
858363000
REGENCE BCBS
OR
Enumeration date
02/02/2007
Last updated
06/08/2011
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