Provider Demographics
NPI:1124228929
Name:CLINTON, REBECCA E (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:E
Last Name:CLINTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:501 N GRAHAM ST
Mailing Address - Street 2:STE 200
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97227-1654
Mailing Address - Country:US
Mailing Address - Phone:503-413-4488
Mailing Address - Fax:503-413-1812
Practice Address - Street 1:501 N GRAHAM ST
Practice Address - Street 2:STE 200
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1654
Practice Address - Country:US
Practice Address - Phone:503-413-4488
Practice Address - Fax:503-413-1812
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD 16123207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery