Spisak, William A

Spisak, William A is an sole proprietor health care provider with primary practice located at 6655 Sw Griffin Dr , Portland OR 97223. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Spisak, William A can be contacted via phone (503) 706-5902.

Contact Information

Primary practice address
6655 Sw Griffin Dr Portland OR 97223
Phone: (503) 706-5902
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X OR13012 Oregon

Profile Details

NPI number 1740274554
LBN Legal business name Spisak, William A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 7th, 2005
Last updated Oct 25th, 2019 - about 7 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 1740274554 NPPES
Oregon Other 110007601 PALMETTO GBA
Oregon MEDICAID 268300 PALMETTO GBA

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