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General NPI Number Information
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NPI Number | 1528260494
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Entity Type | Individual
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Provider Name | ROBERT L TITCHENER PA
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Gender | Male
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 12360 E BURNSIDE ST
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City | PORTLAND
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State | OR
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Zip | 97233-1042
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Country | US
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Telephone | 971-279-4800
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Fax | 971-279-2051
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Provider Business Mailing Address
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Address Line | 211 SE CARUTHERS ST
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City | PORTLAND
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State | OR
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Zip | 97214-4502
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Country | US
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Telephone | 503-224-1044
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Fax | 971-260-0355
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 102690
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License Number State | NC
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