Individual
BRUCE J BIRK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2525 NW LOVEJOY ST, STE 200, PORTLAND, OR 97210-2863
(503) 227-0671
(503) 227-0676
Mailing address
2231 SE ASH ST, PORTLAND, OR 97214-1631
(503) 736-1114
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD21767
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134208
—
OR
Enumeration date
06/22/2005
Last updated
07/08/2007
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