Healthcare Provider Details

I. General information

NPI: 1336744713
Provider Name (Legal Business Name): WEST HILLS ALLERGY AND ASTHMA ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2020
Last Update Date: 06/03/2021
Certification Date: 06/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9701 SW BARNES RD STE 130
PORTLAND OR
97225-6688
US

IV. Provider business mailing address

9701 SW BARNES RD STE 130
PORTLAND OR
97225-6688
US

V. Phone/Fax

Practice location:
  • Phone: 503-297-4779
  • Fax: 503-297-0499
Mailing address:
  • Phone: 503-297-4779
  • Fax: 503-297-0499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State

VIII. Authorized Official

Name: L RENE ANDERSON-COWELL
Title or Position: DOCTOR
Credential: M.D.
Phone: 360-254-4316