Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | MD 17954 | OR |
NPI | 1093701898 |
---|---|
Provider Name | Oisin Ruadri O'neill |
First Address | Portland, OR 97232-2684 |
Second Address | Portland, OR 97225-6625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2005 |
Last Update Date | 02/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
067814 | (05) | OR |
140006376 | RR MEDICARE (01) | |
3873100 | WELFARE (01) | ID |
F91617 | (02) |