Healthcare Provider Details

I. General information

NPI: 1568466282
Provider Name (Legal Business Name): DAVID FINK PFENDLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 01/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15410 NW BAKER CREEK RD
MCMINNVILLE OR
97128-8063
US

IV. Provider business mailing address

15410 NW BAKER CREEK RD
MCMINNVILLE OR
97128-8063
US

V. Phone/Fax

Practice location:
  • Phone: 503-472-4355
  • Fax:
Mailing address:
  • Phone: 503-472-4355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number9514
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: