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:
Health care specialties
| Specialty | Code | License # | 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 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1437102746 | NPPES |
| Minnesota | MEDICAID | 357147500 |
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