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General NPI Number Information
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NPI Number | 1407062037
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Entity Type | Individual
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Provider Name | ROBERT ARTHUR DA PRATO M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7545 NE AMBASSADOR PL
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City | PORTLAND
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State | OR
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Zip | 97220-1367
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Country | US
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Telephone | 503-528-1630
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Fax | 503-528-1641
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Provider Business Mailing Address
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Address Line | 8312 NW HAWKINS BLVD
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City | PORTLAND
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State | OR
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Zip | 97229-8492
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Country | US
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Telephone | 503-292-3723
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Fax |
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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 | 202C00000X
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Taxonomy Name | Independent Medical Examiner Physician
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License Number | MD22859
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License Number State | OR
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