JOHN M CUSTIS

GRESHAM, OR
NPI1770561813
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: OR  MD09069)
Enumeration Date2006-01-09
Last Update Date2007-12-21
Business Address
-- JOHN M CUSTIS MD
24900 SE STARK STE 109
GRESHAM, OR 97030
Phone number: 503-667-1015
Mailing Address
-- JOHN M CUSTIS MD
PO BOX 23200
PORTLAND, OR 97281-3200
Phone number: 503-667-1015