Individual
STEFAN CHRISTISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1120 NW 20TH AVE STE 110, PORTLAND, OR 97209-1591
(503) 413-5542
Mailing address
1120 NW 20TH AVE STE 110, PORTLAND, OR 97209-1591
(503) 413-5542
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO192630
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PG177406
POST GRADUATE LICENSE NUMBER
OR
Enumeration date
07/16/2014
Last updated
05/14/2020
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