Individual
JOSEPH MICHAEL OBADIAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5330 NE GLISAN ST, SUITE 200, PORTLAND, OR 97213-3069
(503) 215-9080
(503) 215-9099
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
2003010752
MO
207N00000X
Dermatology Physician
MD00047161
WA
207N00000X
Dermatology Physician
Primary
MD26968
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028538
—
OR
01
—
H94431
UPIN
OR
01
—
P00973909
RR MEDICARE
OR
Enumeration date
02/15/2007
Last updated
03/22/2021
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