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Individual

MARC A ZENONIANI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1185 SOUTH ELM ST, CANBY, OR 97013
(503) 723-4660
(503) 266-6649
Mailing address
6 CENTERPOINTE DR STE 200, LAKE OSWEGO, OR 97035-8660
(503) 797-2273
(503) 234-8155

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD26839
OR
208000000X
Pediatrics Physician
MD26839
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
240159
OR
Enumeration date
08/01/2006
Last updated
09/29/2010
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