Terry, Mark A
Terry, Mark A is an individual health care provider with primary practice located at 1040 Nw 22Nd Ave #200, Portland OR 97210. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Terry, Mark A can be contacted via phone (503) 413-8202.Contact Information
Primary practice address
1040 Nw 22Nd Ave #200
Portland OR 97210
Phone: (503) 413-8202
Fax: (503) 413-6937
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | MD17016 | Oregon |
Profile Details
| NPI number | 1760498737 |
|---|---|
| LBN Legal business name | Terry, Mark A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 31st, 2006 |
| Last updated | Jan 4th, 2013 - about 12 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 | 1760498737 | NPPES |
| Oregon | MEDICAID | 016514 |
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