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General NPI Number Information
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NPI Number | 1912916990
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Entity Type | Individual
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Provider Name | PATRICK JOSEPH MCGOWAN MD
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Gender | Male
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 05/12/2017
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Provider Practice Location Address
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Address Line | 24900 SE STARK ST STE 202
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City | GRESHAM
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State | OR
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Zip | 97030
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Country | US
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Telephone | 503-465-8887
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Fax | 503-465-8808
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Provider Business Mailing Address
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Address Line | 2222 NW LOVEJOY ST STE 505
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City | PORTLAND
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State | OR
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Zip | 97210-5103
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Country | US
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Telephone | 503-242-9850
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Fax | 503-226-3539
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD18852
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License Number State | OR
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