Healthcare Provider Details

I. General information

NPI: 1528061173
Provider Name (Legal Business Name): MARK SELIGMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 10/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 NE HOYT ST STE 362
PORTLAND OR
97213-2983
US

IV. Provider business mailing address

PO BOX 3378
PORTLAND OR
97208-3378
US

V. Phone/Fax

Practice location:
  • Phone: 503-232-7000
  • Fax: 503-232-8266
Mailing address:
  • Phone: 503-203-1000
  • Fax: 503-203-1010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD11837
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: