Individual
DR. MARK A TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1040 NW 22ND AVE, #200, PORTLAND, OR 97210
(503) 413-8202
(503) 413-6937
Mailing address
PO BOX 4399, PORTLAND, OR 97208-4399
(503) 413-3900
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
MD17016
OR
207WX0120X
Cornea and External Diseases Specialist Physician
Primary
MD17016
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016514
—
OR
Enumeration date
07/31/2006
Last updated
07/08/2025
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