Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 8383 | OR |
NPI | 1508850967 |
---|---|
Provider Name | Morris Button |
First Address | Portland, OR 97215-3255 |
Second Address | Portland, OR 97215-3255 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2005 |
Last Update Date | 15/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009857000 | REGENCE BLUE CROSS (01) | OR |
029835 | (05) | OR |
400000761 | MC RR (01) | OR |
C92337 | (02) |