Healthcare Provider Details

I. General information

NPI: 1942334123
Provider Name (Legal Business Name): VINCENT A TORRES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 11/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4805 NE GLISAN ST
PORTLAND OR
97213
US

IV. Provider business mailing address

9155 SW BARNES RD STE 420
PORTLAND OR
97225-6631
US

V. Phone/Fax

Practice location:
  • Phone: 503-215-6000
  • Fax:
Mailing address:
  • Phone: 503-297-6334
  • Fax: 503-297-2360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA99174
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD28912
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: