Individual
DR. JOHN STEPHEN DOMREIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1510 DIVISION ST STE 210, OREGON CITY, OR 97045-1599
(503) 723-6525
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD24678
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227359
—
OR
01
—
858363001
REGENCE BC/BS OR
OR
Enumeration date
10/13/2006
Last updated
04/26/2022
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