MEDICARE: JAMES V SKAVARIL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD20409	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336172956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES V SKAVARIL MD

Provider Business Mailing Address
First Line	:	5050 NE HOYT ST STE 203
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97213-2956
Country	:	US
Telephone Number	:	503-230-9224
Fax Number	:	503-230-9201

Provider Business Practice Location Address
First Line	:	5050 NE HOYT ST STE 203
Second Line	:	SUITE 120
City	:	PORTLAND
State	:	OR
Zip	:	97213-2956
Country	:	US
Telephone Number	:	503-230-9224
Fax Number	:	503-230-9201

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	01/13/2009

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Directions to “ JAMES V SKAVARIL MD” Practice Location

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