Deffebach, Mark Elbert

Deffebach, Mark Elbert is an individual health care provider with primary practice located at 3181 Sw Sam Jackson Park Rd , Portland OR 97239-3011. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Deffebach, Mark Elbert can be contacted via phone (503) 494-1620.

Contact Information

Primary practice address
3181 Sw Sam Jackson Park Rd Portland OR 97239-3011
Phone: (503) 494-1620
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X MD22999 Oregon
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X MD22999 Oregon

Profile Details

NPI number 1164529939
LBN Legal business name Deffebach, Mark Elbert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1164529939 NPPES
Oregon MEDICAID 287493

Popular Providers