Individual
JOHN E GODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4805 NE GLISAN ST STE 6N40, PORTLAND, OR 97213-2933
(503) 215-5696
(217) 545-4788
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
Primary
MD157208
OR
207RH0003X
Hematology & Oncology Physician
MD157208
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36070909
—
IL
05
—
500649299
—
OR
Enumeration date
12/30/2005
Last updated
01/18/2021
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