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Individual

DR. MITCHELL BRETT SALLY

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) 494-8311
Mailing address
3908 NE 74TH AVE, PORTLAND, OR 97213-5727
(503) 679-3206

Taxonomy

Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
MD28096
OR
2086S0127X
Trauma Surgery Physician
Primary
MD28096
OR

Other

Enumeration date
06/18/2007
Last updated
06/20/2013
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