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Individual

DR. JOHN H. DEGENHARDT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
707 SW WASHINGTON ST, SUITE 700, PORTLAND, OR 97205-3536
(503) 299-9906
(503) 225-9002
Mailing address
PO BOX 2040, PORTLAND, OR 97208-2040
(503) 299-9906
(503) 225-9002

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
DO16501
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010251
OR
01
050056535
RR MEDICARE
OR
05
1058940
WA
05
MD701OR
AK
05
XPY188986
CA
Enumeration date
02/17/2006
Last updated
09/09/2013
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