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Organization

ALLERGY CLINIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARK THOMAS O'HOLLAREN M.D. (OWNER)
(503) 228-0155
Entity
Organization

Contact information

Practice address
511 SW 10TH AVE, SUITE 1301, PORTLAND, OR 97205-2732
(503) 228-0155
(503) 226-8342
Mailing address
511 SW 10TH AVE, SUITE 1301, PORTLAND, OR 97205-2732
(503) 228-0155
(503) 226-8342

Taxonomy

Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
13450
OR

Other

Enumeration date
04/19/2007
Last updated
08/22/2020
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