Brian Jacob Stater
Otolaryngologist (ENT Doctor)
9155 Sw Barnes Rd Ste 536
Portland
, Oregon 97225-6785
Brian Jacob Stater
Otolaryngologist (ENT Doctor)
9155 Sw Barnes Rd Ste 536
Portland
, Oregon 97225-6785
(503) 963-2825
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About
Features
Specialties
- Otolaryngologist (ENT Doctor)
Languages spoken
- English
Location
First Address
- Brian Jacob Stater
- 847 Ne 19th Suite 300
- Portland, OR
- Zip : 97232
- Fax : (503) 963-2825
- Phone : (503) 963-2801
Second Address
- Brian Jacob Stater
- 9155 Sw Barnes Rd Ste 536
- Portland, OR
- Zip : 97225-6785
- Fax : (503) 935-8110
- Phone : (503) 935-8100
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD182454 | OR |
National Provider Identifier
| NPI | 1063702835 |
|---|---|
| Provider Name | Brian Jacob Stater |
| First Address | Portland, OR 97232 |
| Second Address | Portland, OR 97225-6785 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/04/2011 |
| Last Update Date | 24/11/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 500725530 | (05) | OR |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.