Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | DO168057 | OR |
N | 2084N0400X | Neurologist | LL1267 | SC |
N | 2084N0600X | Clinical Neurophysiologist | DO168057 | OR |
NPI | 1033347349 |
---|---|
Provider Name | Dr. Matthew Grant Mccaskill |
First Address | Portland, OR 97239-3011 |
Second Address | Portland, OR 97239-3011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2009 |
Last Update Date | 20/03/2015 |