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Individual

DR. KENNETH MICHAEL ETTINGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3550 N INTERSTATE AVE, PORTLAND, OR 97227-1196
(503) 285-9321
(503) 331-6450
Mailing address
3550 N INTERSTATE AVE, PORTLAND, OR 97227-1196
(503) 285-9321
(503) 331-6450

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
MD00027111
WA
207K00000X
Allergy & Immunology Physician
Primary
MD13428
OR

Other

Enumeration date
08/19/2006
Last updated
02/04/2022
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