Individual
MR. MICHAEL PATRICK MALLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1253 NW CANAL BLVD, REDMOND, OR 97756-1334
(541) 548-8131
(541) 460-4028
Mailing address
1253 NW CANAL BLVD, REDMOND, OR 97756-1334
(541) 548-8131
(541) 460-4028
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
7152242-8905
UT
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
MD182712
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500725416
—
OR
Enumeration date
10/08/2008
Last updated
11/01/2022
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