Provider Demographics
NPI:1932110988
Name:MEUNIER, PAUL ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:ANTHONY
Last Name:MEUNIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23200
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97281-3200
Mailing Address - Country:US
Mailing Address - Phone:503-619-1100
Mailing Address - Fax:503-619-1101
Practice Address - Street 1:1500 NW BETHANY BLVD
Practice Address - Street 2:STE 100
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-5233
Practice Address - Country:US
Practice Address - Phone:503-619-1100
Practice Address - Fax:503-619-1101
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD162982085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR003009Medicaid
E32828Medicare UPIN
OR003009Medicaid