Willis, Gregory S
Willis, Gregory S is an individual health care provider with primary practice located at 6489 Sw Borland Rd , Tualatin OR 97062-9798. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Radiation Oncology, Technologists, Technicians & Other Technical Service Providers / Radiation Therapy. Allopathic & Osteopathic Physicians / Radiation Oncology is his primary health care specialty. Willis, Gregory S can be contacted via phone (503) 692-4843.Contact Information
Primary practice address
6489 Sw Borland Rd
Tualatin OR 97062-9798
Phone: (503) 692-4843
Fax: (503) 692-6543
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Radiation Oncology | 2085R0001X | MD28019 | Oregon |
| Technologists, Technicians & Other Technical Service Providers / Radiation Therapy | 2471R0002X | MD28019 | Oregon |
Profile Details
| NPI number | 1417941600 |
|---|---|
| LBN Legal business name | Willis, Gregory S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 2nd, 2005 |
| Last updated | Jul 16th, 2008 - about 18 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 | 1417941600 | NPPES |
| Oregon | Other | 033138015 | REGENCE BCBS |
| Oregon | Other | 140838 | REGENCE BCBS |
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