Provider Demographics
NPI:1467425629
Name:WAHLS, STEVEN A (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:A
Last Name:WAHLS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:51377 SW OLD PORTLAND RD STE C
Mailing Address - Street 2:OHSU FAMILY MEDICINE AT SCAPPOOSE
Mailing Address - City:SCAPPOOSE
Mailing Address - State:OR
Mailing Address - Zip Code:97056-4023
Mailing Address - Country:US
Mailing Address - Phone:503-418-4222
Mailing Address - Fax:503-418-4223
Practice Address - Street 1:51377 SW OLD PORTLAND RD STE C
Practice Address - Street 2:OHSU FAMILY MEDICINE AT SCAPPOOSE
Practice Address - City:SCAPPOOSE
Practice Address - State:OR
Practice Address - Zip Code:97056-4023
Practice Address - Country:US
Practice Address - Phone:503-418-4222
Practice Address - Fax:503-418-4223
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD13885207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR080122426OtherIND RAILROAD
OR115741Medicaid
ORJ406418OtherIND PACSOURCE
OR00188007OtherIND BLUE CROSS
OR101325Medicare ID - Type UnspecifiedIND MEDICARE
OR115741Medicaid