Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | MD14838 | OR |
N | 207RH0003X | Hematology & Oncology | MD14838 | OR |
NPI | 1063427581 |
---|---|
Provider Name | Dr. Thomas Grier Deloughery |
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 | 31/07/2006 |
Last Update Date | 24/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
025804 | (05) | OR |
C91466 | (02) |