Prendergast, William John
Prendergast, William John is an individual health care provider with primary practice located at 1955 Nw Northrup St , Portland OR 97209-1614. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Prendergast, William John can be contacted via phone (503) 227-2020.Contact Information
Primary practice address
1955 Nw Northrup St
Portland OR 97209-1614
Phone: (503) 227-2020
Fax: (503) 222-0614
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | MD07423 | Oregon |
Profile Details
| NPI number | 1407838477 |
|---|---|
| LBN Legal business name | Prendergast, William John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 16th, 2005 |
| Last updated | Jul 13th, 2026 - about 3 months 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 | 1407838477 | NPPES |
| Oregon | MEDICAID | 151092 |
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