Organization
PATRICK RADECKI, M.D. A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK L. RADECKI MD (OWNER)
(503) 222-3638
Entity
Organization
Contact information
Practice address
2222 NW LOVEJOY ST STE 607, PORTLAND, OR 97210-5104
(503) 222-3638
(503) 222-3638
Mailing address
2222 NW LOVEJOY ST STE 607, PORTLAND, OR 97210-5104
(503) 222-3638
(503) 222-3638
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD13579
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291880
—
OR
Enumeration date
01/11/2007
Last updated
10/13/2008
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