Willis, Dale Michael

Willis, Dale Michael is an individual health care provider with primary practice located at 9155 Sw Barnes Rd Suite 931, Portland OR 97225-6636. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Endocrinology, which is considered as his primary health care specialty. Willis, Dale Michael can be contacted via phone (503) 216-6050.

Contact Information

Primary practice address
9155 Sw Barnes Rd Suite 931 Portland OR 97225-6636
Phone: (503) 216-6050
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Endocrinology 2080P0205X MD22738 Oregon

Profile Details

NPI number 1013978378
LBN Legal business name Willis, Dale Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated Mar 4th, 2015 - about 11 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 1013978378 NPPES
Oregon MEDICAID 287841

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