Individual
DR. ETHAN EMMET CORCORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
10180 SE SUNNYSIDE RD, DEPT PULMONARY/CRITICAL CARE, KAISER SUNNYSIDE MED CTR, CLACKAMAS, OR 97015-8970
(503) 571-2727
Mailing address
3151 SW SHERWOOD PL, PORTLAND, OR 97201-2254
(503) 222-1346
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD150309
OR
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD150309
OR
207RP1001X
Pulmonary Disease Physician
Primary
MD150309
OR
Other
Enumeration date
04/20/2007
Last updated
03/12/2014
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