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1740296243
STEPHEN JAY DATENA
PORTLAND, OR
NPI
1740296243
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208600000X Surgery
(Licence: OR MD18504)
Enumeration Date
2006-08-01
Last Update Date
2007-07-08
Business Address
STEPHEN JAY DATENA MD
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3011
Phone number: 503-494-8372
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Mailing Address
STEPHEN JAY DATENA MD
3535 NE 29TH AVE
PORTLAND, OR 97212-1609
Phone number:
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