Individual
AMY S EARHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
703 NE HANCOCK ST, PORTLAND, OR 97212-3955
(503) 230-9875
(503) 230-9877
Mailing address
211 SE CARUTHERS ST, PORTLAND, OR 97214-4502
(503) 224-1044
(971) 260-0355
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD00031951
WA
207Q00000X
Family Medicine Physician
Primary
MD19531
OR
207QG0300X
Geriatric Medicine (Family Medicine) Physician
MD19531
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1039937
—
WA
05
—
182930
—
OR
Enumeration date
09/22/2006
Last updated
05/30/2025
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