Individual
WILLIAM G BENNETT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 413-4032
(503) 227-0218
Mailing address
2701 NW VAUGHN ST, STE 425, PORTLAND, OR 97210
(503) 227-2400
(503) 227-0218
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD08737
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013946
—
OR
01
—
MD08737
LICENSE
OR
Enumeration date
06/16/2006
Last updated
07/08/2007
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