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Individual

DR. BARBARA J. LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD MPH

Contact information

Practice address
2055 NW SAVIER ST, SUITE 201, PORTLAND, OR 97209-1770
(503) 494-1414
Mailing address
707 SW GAINES ST, PORTLAND, OR 97239-2901
(503) 494-4127
(503) 494-1542

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
G65750
CA
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MD126297
OR
2080S0010X
Pediatric Sports Medicine Physician
G65750
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G657500
CA
Enumeration date
07/05/2006
Last updated
02/13/2014
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