Individual
DR. JOHN DENKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5622 SE 41ST AVE, PORTLAND, OR 97202-7516
(503) 774-6929
(503) 774-6924
Mailing address
5622 SE 41ST AVE, PORTLAND, OR 97202-7516
(503) 774-6929
(503) 774-6924
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
MD 12668
OR
207QG0300X
Geriatric Medicine (Family Medicine) Physician
MD 12668
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
228700
—
OR
01
—
930862374
TRICARE
—
Enumeration date
08/03/2005
Last updated
10/16/2007
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