Healthcare Provider Details

I. General information

NPI: 1609982628
Provider Name (Legal Business Name): STEVE MARK SNYDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: STEPHEN MARK SNYDER MD

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 03/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10180 SE SUNNYSIDE RD
CLACKAMAS OR
97015-8970
US

IV. Provider business mailing address

10180 SE SUNNYSIDE RD
CLACKAMAS OR
97015-8970
US

V. Phone/Fax

Practice location:
  • Phone: 503-652-2880
  • Fax:
Mailing address:
  • Phone: 503-571-8487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD13883
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: