Individual
DR. CRAIG KEVIN HERTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2222 NW LOVEJOY ST, PORTLAND, OR 97210-5104
(503) 222-3638
(503) 223-5139
Mailing address
2222 NW LOVEJOY ST, PORTLAND, OR 97210-5104
(503) 222-3638
(503) 223-5139
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD14722
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012893
—
OR
Enumeration date
09/22/2005
Last updated
11/07/2023
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