Korngold, Ethan Chauncey
Korngold, Ethan Chauncey is an individual health care provider with primary practice located at 9427 Sw Barnes Rd Suite 498, Portland OR 97225-6652. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Korngold, Ethan Chauncey can be contacted via phone (503) 216-0900.Contact Information
Primary practice address
9427 Sw Barnes Rd Suite 498
Portland OR 97225-6652
Phone: (503) 216-0900
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 217916 | Massachusetts |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | MD29224 | Oregon |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 217916 | Massachusetts |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | MD60107167 | Washington |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | MD29224 | Oregon |
Profile Details
| NPI number | 1568452738 |
|---|---|
| LBN Legal business name | Korngold, Ethan Chauncey |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 27th, 2005 |
| Last updated | Mar 19th, 2021 - about 3 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 | 1568452738 | NPPES |
| Oregon | Other | P00848656 | RR MEDICARE |
| Oregon | MEDICAID | 500609355 | RR MEDICARE |
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