Provider Demographics
NPI:1518026863
Name:PFEIFER, GARTH PAUL
Entity Type:Individual
Prefix:
First Name:GARTH
Middle Name:PAUL
Last Name:PFEIFER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 S.E. OAK ST.
Mailing Address - Street 2:SUITE F
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123
Mailing Address - Country:US
Mailing Address - Phone:503-547-8529
Mailing Address - Fax:503-547-8529
Practice Address - Street 1:620 SE OAK ST
Practice Address - Street 2:SUITE F
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4160
Practice Address - Country:US
Practice Address - Phone:503-547-8529
Practice Address - Fax:503-547-8529
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1309660001Medicare NSC