Dr. Dale Michael Willis
Pediatric Endocrinologist
9155 Sw Barnes Rd Suite 931
Portland
, Oregon 97225-6636
Dr. Dale Michael Willis
Pediatric Endocrinologist
9155 Sw Barnes Rd Suite 931
Portland
, Oregon 97225-6636
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About
Features
Specialties
- Pediatric Endocrinologist
Languages spoken
- English
Location
First Address
- Dr. Dale Michael Willis
- Po Box 3158
- Portland, OR
- Zip : 97208-3158
- Phone :
Second Address
- Dr. Dale Michael Willis
- 9155 Sw Barnes Rd Suite 931
- Portland, OR
- Zip : 97225-6636
- Phone : (503) 216-6050
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080P0205X | Pediatric Endocrinologist | MD22738 | OR |
National Provider Identifier
| NPI | 1013978378 |
|---|---|
| Provider Name | Dr. Dale Michael Willis |
| First Address | Portland, OR 97208-3158 |
| Second Address | Portland, OR 97225-6636 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/03/2006 |
| Last Update Date | 04/03/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 287841 | (05) | OR |
| F40451 | (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.