Individual
THEODORE J LOWENKOPF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9135 SW BARNES RD, STE 461, PORTLAND, OR 97225-6646
(503) 216-1150
(971) 282-0086
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
110269
AK
2084N0400X
Neurology Physician
37334
MT
2084N0400X
Neurology Physician
G142299
CA
2084N0400X
Neurology Physician
MD22219
OR
2084N0400X
Neurology Physician
MD60217458
WA
2084V0102X
Vascular Neurology Physician
Primary
MD22219
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130328
—
OR
01
—
P00777837
RR MEDICARE
OR
Enumeration date
11/09/2005
Last updated
11/25/2022
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