Healthcare Provider Details

I. General information

NPI: 1205934866
Provider Name (Legal Business Name): ANDREW FRANK ZIGMAN M.D., C.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 02/04/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9427 SW BARNES RD
PORTLAND OR
97225-6652
US

IV. Provider business mailing address

12015 SW SYLVANIA CT
PORTLAND OR
97219-8293
US

V. Phone/Fax

Practice location:
  • Phone: 503-203-2040
  • Fax:
Mailing address:
  • Phone: 503-977-0377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberA53689
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberMD22941
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: