Provider Demographics
NPI:1982639480
Name:BARKHUIZEN, ANDRE (MD)
Entity Type:Individual
Prefix:MR
First Name:ANDRE
Middle Name:
Last Name:BARKHUIZEN
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 1:10230 SW CAPITOL HWY
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-6809
Mailing Address - Country:US
Mailing Address - Phone:503-244-3162
Mailing Address - Fax:503-244-3166
Practice Address - Street 1:10230 SW CAPITOL HWY
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-6809
Practice Address - Country:US
Practice Address - Phone:503-244-3162
Practice Address - Fax:503-244-3166
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD20458207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
R134141Medicare ID - Type Unspecified
G02321Medicare UPIN