Individual
DR. MATTHEW DAVID ORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1500 DIVISION ST, OREGON CITY, OR 97045-1527
(541) 758-5047
Mailing address
PO BOX 2156, CORVALLIS, OR 97339-2156
(541) 758-5047
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
DO28962
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500605382
—
OR
05
—
8540163
—
WA
01
—
P00741857
RAILROAD MEDICARE PTAN
OR
Enumeration date
04/12/2007
Last updated
10/30/2009
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