Koon, David C

Koon, David C is an individual health care provider with primary practice located at 1040 Nw 22Nd Ave Suite 320, Portland OR 97210-3057. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Koon, David C can be contacted via phone (503) 413-6294.

Contact Information

Primary practice address
1040 Nw 22Nd Ave Suite 320 Portland OR 97210-3057
Fax: (503) 413-7780
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X MD23367 Oregon

Profile Details

NPI number 1528043205
LBN Legal business name Koon, David C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2005
Last updated Jul 8th, 2007 - about 17 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 1528043205 NPPES
Oregon MEDICAID 287563

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