Individual
OLEG MAKSIMOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
689 NW BURNSIDE RD FL 2, GRESHAM, OR 97030-3739
(503) 382-8106
(503) 382-8100
Mailing address
689 NW BURNSIDE RD FL 1, GRESHAM, OR 97030-3739
(503) 382-8106
(503) 382-8100
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
MD431737
PA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
MD28526
OR
Other
Enumeration date
08/31/2006
Last updated
09/14/2021
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