Michael Patrick Collins, LMT
Individual provider Active NPI Contractor · Beaverton, OR
NPI 1033249339 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1033249339
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- 6501 (OR)
- Practice address
- 11385 SW Scholls Ferry Rd
Beaverton, OR 97008-7167 - Phone
- (503) 524-9040
- NPI assigned
- Mar 6, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6501 | OR | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 6501 | OR | Yes |
Addresses
Primary practice location
11385 SW Scholls Ferry Rd
Beaverton, OR 97008-7167
Mailing address
13543 SW 64TH Ave
Portland, OR 97219-8054
Phone (503) 349-2710
Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.