Individual
MARK E MCDONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2908 NE KILLINGSWORTH ST, PORTLAND, OR 97211-6812
(503) 228-7134
Mailing address
667 NW ANGELINE AVE, GRESHAM, OR 97030-5321
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
12/05/2007
Last updated
12/05/2007
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