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NPI Code Detail

MEDICARE: ANDREW GEOFFREY NANTON M.D.

MEDICARE: ANDREW GEOFFREY NANTON M.D.
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
12084F0202XForensic Psychiatry PhysicianMD161367OR

General Provider Information

NPI Number : 1962604603
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW GEOFFREY NANTON M.D.
Provider Business Mailing Address
First Line : PO BOX 2355
Second Line :
City : TUALATIN
State : OR
Zip : 97062-2355
Country : US
Telephone Number : 503-479-5759
Fax Number :
Provider Business Practice Location Address
First Line : 8915 SW CENTER ST
Second Line :
City : TIGARD
State : OR
Zip : 97223-6307
Country : US
Telephone Number : 503-726-3690
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2007
Last Update Date : 03/10/2015

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