Individual
DR. DANIEL JAMES SISCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
N.D.
Contact information
Practice address
3351 NE BROADWAY ST, PORTLAND, OR 97232-1816
(503) 282-9222
(503) 282-8116
Mailing address
3351 NE BROADWAY ST, PORTLAND, OR 97232-1816
(503) 282-9222
(503) 282-8116
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
000536
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
27805-1
—
OR
Enumeration date
01/22/2007
Last updated
07/09/2007
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