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General NPI Number Information
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NPI Number | 1710909650
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Entity Type | Organization
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Legal Business Name | STANLEY L. COHAN, MD, CHARTERED
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9427 SW BARNES RD SUITE 595
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City | PORTLAND
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State | OR
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Zip | 97225-6652
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Country | US
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Telephone | 503-296-9242
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Fax | 503-296-9856
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Provider Business Mailing Address
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Address Line | 9427 SW BARNES RD SUITE 595
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City | PORTLAND
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State | OR
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Zip | 97225-6652
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Country | US
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Telephone | 503-296-9242
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Fax | 503-296-9856
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. STANLEY L. COHAN
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Credential | MD, PHD
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Telephone | 503-296-9242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD22113
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License Number State | OR
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