Individual
DR. WILLIAM A SPISAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6655 SW GRIFFIN DR, PORTLAND, OR 97223
(503) 706-5902
Mailing address
5050 NE HOYT ST, SUITE 203, PORTLAND, OR 97213-2991
(503) 282-7731
(503) 230-9201
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OR13012
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110007601
PALMETTO GBA
OR
05
—
268300
—
OR
Enumeration date
09/07/2005
Last updated
10/25/2019
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