Individual
JUSTIN E OSBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10330 SE 32ND AVE STE 205, MILWAUKIE, OR 97222-6594
(503) 513-8950
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD00028916
WA
207Q00000X
Family Medicine Physician
Primary
MD176531
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0231720
L&I
WA
05
—
1649355462
—
WA
Enumeration date
10/27/2006
Last updated
03/22/2021
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