Provider Demographics
NPI:1275037020
Name:MARSH, DANIEL ERIC JR (DO)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ERIC
Last Name:MARSH
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14290 MARJORIE LN APT 2098
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-7863
Mailing Address - Country:US
Mailing Address - Phone:503-826-7304
Mailing Address - Fax:
Practice Address - Street 1:14290 MARJORIE LN APT 2098
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-7863
Practice Address - Country:US
Practice Address - Phone:503-826-7304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0000000002081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty