Individual
DR. RICHARD C MANTHEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1321 NE 99TH AVE, SUITE 100, PORTLAND, OR 97220-9436
(503) 215-9900
(503) 215-4025
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD.018258
LA
207R00000X
Internal Medicine Physician
Primary
MD28549
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500610065
—
OR
01
—
MD28549
LICENSE
OR
01
—
P00893292
RR MEDICARE - PHS
OR
Enumeration date
05/15/2006
Last updated
03/22/2021
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