Individual
MARK T BUCHHOLZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 283-5220
(503) 283-9527
Mailing address
PO BOX 821350, VANCOUVER, WA 98682-0030
(503) 283-5220
(503) 283-9527
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD25508
OR
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
MD25508
OR
Other
Enumeration date
11/09/2005
Last updated
12/16/2022
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