MEDICARE: ALLARD J. CONGER 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	207V00000X	Obstetrics & Gynecology Physician	MD11759	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	:	1508857723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLARD J. CONGER MD

Provider Business Mailing Address
First Line	:	19250 SW 65TH AVE
Second Line	:	SUITE 300
City	:	TUALATIN
State	:	OR
Zip	:	97062-7452
Country	:	US
Telephone Number	:	503-692-1242
Fax Number	:	503-691-3615

Provider Business Practice Location Address
First Line	:	19250 SW 65TH AVE
Second Line	:	SUITE 300
City	:	TUALATIN
State	:	OR
Zip	:	97062-7452
Country	:	US
Telephone Number	:	503-692-1242
Fax Number	:	503-691-3615

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

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	10/03/2007

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Directions to “ ALLARD J. CONGER MD” Practice Location

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