Koeller, David Martin
Koeller, David Martin 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 / Clinical Biochemical Genetics, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Clinical Biochemical Genetics is his primary health care specialty. Koeller, David Martin can be contacted via phone (503) 494-7859.Contact Information
Primary practice address
3181 Sw Sam Jackson Park Rd
Portland OR 97239-3011
Phone: (503) 494-7859
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Clinical Biochemical Genetics | 207SG0202X | MD22656 | Oregon |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD22656 | Oregon |
Profile Details
| NPI number | 1629086145 |
|---|---|
| LBN Legal business name | Koeller, David Martin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 3rd, 2006 |
| Last updated | Jul 11th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629086145 | NPPES |
| Oregon | MEDICAID | 287980 |
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