Douglas Craig Walta
Gastroenterologist
1111 Ne 99th Ave Suite 301
Portland
, Oregon 97220-9428
Douglas Craig Walta
Gastroenterologist
1111 Ne 99th Ave Suite 301
Portland
, Oregon 97220-9428
(503) 963-9505
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About
Features
Specialties
- Gastroenterologist
Languages spoken
- English
Location
First Address
- Douglas Craig Walta
- 975 Se Sandy Blvd Suite 200
- Portland, OR
- Zip : 97214-1308
- Fax : (503) 963-9505
- Phone : (503) 963-2846
Second Address
- Douglas Craig Walta
- 1111 Ne 99th Ave Suite 301
- Portland, OR
- Zip : 97220-9428
- Fax : (503) 963-2802
- Phone : (503) 963-2707
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RG0100X | Gastroenterologist | MD09846 | OR |
National Provider Identifier
| NPI | 1023001195 |
|---|---|
| Provider Name | Douglas Craig Walta |
| First Address | Portland, OR 97214-1308 |
| Second Address | Portland, OR 97220-9428 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/08/2005 |
| Last Update Date | 05/08/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1872308 | (05) | WA |
| 230979 | (05) | OR |
| C91292 | (02) | 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.