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Individual

DR. DAVID BRUCE MITCHELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
13636 SE TARALON DR, CLACKAMAS, OR 97015
(503) 266-5500
Mailing address
13636 SE TARALON DR, CLACKAMAS, OR 97015
(503) 266-5500

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD15466
OR
208D00000X
General Practice Physician
Primary
MD15466
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
023234
OR
Enumeration date
08/17/2006
Last updated
07/18/2015
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