De Looze, Theodore H.
De Looze, Theodore H. is an individual health care provider with primary practice located at 707 Sw Washington St Suite 700, Portland OR 97205-3536. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. De Looze, Theodore H. can be contacted via phone (503) 299-9906.Contact Information
Primary practice address
707 Sw Washington St Suite 700
Portland OR 97205-3536
Phone: (503) 299-9906
Fax: (503) 225-9002
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | MD12883 | Oregon |
Profile Details
| NPI number | 1730154410 |
|---|---|
| LBN Legal business name | De Looze, Theodore H. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 17th, 2006 |
| Last updated | Sep 9th, 2013 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730154410 | NPPES |
| Oregon | MEDICAID | 041090 | |
| Oregon | MEDICAID | 1073063 | |
| Oregon | MEDICAID | 1730154410 | |
| Oregon | Other | 050033645 | |
| Oregon | MEDICAID | MD641OR |
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