Engelstad, Mark E

Engelstad, Mark E 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 Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery is his primary health care specialty. Engelstad, Mark E can be contacted via phone (503) 494-8914.

Contact Information

Primary practice address
3181 Sw Sam Jackson Park Rd Portland OR 97239-3011
Phone: (503) 494-8914
Fax: (503) 494-0294
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X DF0023 Oregon
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X MD153490 Oregon

Profile Details

NPI number 1437102746
LBN Legal business name Engelstad, Mark E
Credentials MD, DDS
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2006
Last updated Oct 10th, 2017 - about 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437102746 NPPES
Minnesota MEDICAID 357147500

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