Individual
CHARLES DAYRIT LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-6594
Mailing address
3181 SW SAM JACKSON PARK RD, MAIL CODE L586, PORTLAND, OR 97239-3011
(503) 494-8534
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
MD23375
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287397
—
OR
05
—
8286643
—
WA
01
—
830007903
RAILROAD MEDICARE
OR
01
—
93125743797239A141
TRIWEST
OR
Enumeration date
10/19/2006
Last updated
07/26/2007
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