MEDICARE: DR. ROBERT PENTZ BARLOW MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD16505	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902842081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT PENTZ BARLOW MD

Provider Business Mailing Address
First Line	:	PO BOX 3777
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97208-3777
Country	:	US
Telephone Number	:	503-413-3900
Fax Number	:	503-413-3710

Provider Business Practice Location Address
First Line	:	2725 SW CEDAR HILLS BLVD STE 250
Second Line	:
City	:	BEAVERTON
State	:	OR
Zip	:	97005-1344
Country	:	US
Telephone Number	:	503-415-4060
Fax Number	:	503-415-4061

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	12/07/2018

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