Organization
FREDERICK T WALLER MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURI A DAYTON (OFFICE MANAGER)
(503) 292-7398
Entity
Organization
Contact information
Practice address
9155 SW BARNES RD STE 211, PORTLAND, OR 97225-6629
(503) 520-1260
(503) 469-9176
Mailing address
9155 SW BARNES RD STE 211, PORTLAND, OR 97225-6629
(503) 520-1260
(503) 469-9176
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MD08927
OR
Other
Enumeration date
06/20/2007
Last updated
08/22/2020
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