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Organization

RICHARD S POLIN PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICHARD SANDERS POLIN MD (OWNER)
(503) 666-8149
Entity
Organization

Contact information

Practice address
24900 SE STARK ST, SUITE 208, GRESHAM, OR 97030-3355
(503) 666-8139
(503) 666-3434
Mailing address
PO BOX 25714, PORTLAND, OR 97298-0714
(503) 666-8139
(503) 666-3434

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MD 25930
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1043373996
INDIVIDUAL NPI
OR
Enumeration date
10/12/2012
Last updated
10/12/2012
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