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Individual

MARK GREGORY GARZOTTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7760
Mailing address
1520 SE 54TH AVE, PORTLAND, OR 97215-3328

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD22159
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
130355
OR
Enumeration date
07/31/2006
Last updated
07/26/2011
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