Healthcare Provider Details

I. General information

NPI: 1346218542
Provider Name (Legal Business Name): JOHN ANDREW MCQUESTON SR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 02/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N GRAHAM ST SUITE 320
PORTLAND OR
97227-1654
US

IV. Provider business mailing address

501 N GRAHAM ST SUITE 320
PORTLAND OR
97227-1654
US

V. Phone/Fax

Practice location:
  • Phone: 503-459-4540
  • Fax: 503-284-6428
Mailing address:
  • Phone: 503-459-4540
  • Fax: 503-284-6428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number23745
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: