Healthcare Provider Details
I. General information
NPI: 1417911959
Provider Name (Legal Business Name): WILLIAM FRANCIS MARSHALL JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/13/2006
Last Update Date: 11/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
300 N GRAHAM ST SUITE 420
PORTLAND OR
97227-1683
US
IV. Provider business mailing address
300 N GRAHAM ST SUITE 420
PORTLAND OR
97227-1683
US
V. Phone/Fax
- Phone: 503-281-5139
- Fax: 503-249-3782
- Phone: 503-281-5139
- Fax: 503-249-3782
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0206X |
| Taxonomy | Pediatric Gastroenterology Physician |
| License Number | MD16323 |
| License Number State | OR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: