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General NPI Number Information
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NPI Number | 1053586016
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Entity Type | Individual
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Provider Name | BRIAN L PUSKAS MD
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Gender | Male
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 03/07/2017
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Provider Practice Location Address
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Address Line | 15755 SW SEQUOIA PKWY STE 200
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City | TIGARD
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State | OR
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Zip | 97224-7166
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Country | US
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Telephone | 503-639-6002
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Fax | 503-639-1403
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Provider Business Mailing Address
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Address Line | 15755 SW SEQUOIA PKWY STE 200
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City | TIGARD
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State | OR
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Zip | 97224-7166
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Country | US
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Telephone | 503-639-6002
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Fax | 503-639-1403
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME107071
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MD153962
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License Number State | OR
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