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Individual

DR. MARK LAWRENCE SILEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD, MBA

Contact information

Practice address
2552 NW MILDRED ST, PORTLAND, OR 97210-3337
(503) 310-9611
Mailing address
2552 NW MILDRED ST, PORTLAND, OR 97210-3337

Taxonomy

Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
MD22074
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
134165
OR
Enumeration date
07/31/2006
Last updated
04/02/2013
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