Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 3513 | OR |
NPI | 1164642658 |
---|---|
Provider Name | Dr. Hans Christian Andersen |
First Address | Portland, OR 97214-6307 |
Second Address | Portland, OR 97214-6307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 08/07/2007 |