Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MD181770 | OR |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD181770 | OR |
NPI | 1518209840 |
---|---|
Provider Name | Ian Christopher Fields |
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 | 25/03/2013 |
Last Update Date | 16/03/2021 |