Healthcare Provider Details

I. General information

NPI: 1932109733
Provider Name (Legal Business Name): R STERLING HODGSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 NW VAUGHN ST STE 150
PORTLAND OR
97210-5379
US

IV. Provider business mailing address

541 NE 20TH AVE STE 225
PORTLAND OR
97232-2895
US

V. Phone/Fax

Practice location:
  • Phone: 503-229-8455
  • Fax: 503-229-7028
Mailing address:
  • Phone: 503-963-2801
  • Fax: 503-963-2825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License NumberMD14013
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: