Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | MD181603 | OR |
Y | 207RC0000X | Internist - Cardiovascular Disease | MD181603 | OR |
NPI | 1396061834 |
---|---|
Provider Name | Daniel Eric Westerdahl |
First Address | Portland, OR 97208-3158 |
Second Address | Portland, OR 97225-6612 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2010 |
Last Update Date | 25/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
500726109 | (05) | OR |