Pedersen, Andrew Dale

Pedersen, Andrew Dale is an individual health care provider with primary practice located at 5050 Ne Hoyt St Suite 655, Portland OR 97213-2991. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Pedersen, Andrew Dale can be contacted via phone (503) 488-2400.

Contact Information

Primary practice address
5050 Ne Hoyt St Suite 655 Portland OR 97213-2991
Phone: (503) 488-2400
Fax: (503) 231-0121
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X MD60381043 Washington
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X MD19567 Oregon

Profile Details

NPI number 1548235393
LBN Legal business name Pedersen, Andrew Dale
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 22nd, 2006
Last updated Dec 5th, 2023 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548235393 NPPES
Oregon MEDICAID 080320
Oregon MEDICAID 8448896

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