Provider Demographics
NPI:1003925157
Name:NORTH, FERHAN CHESTER (MD, PHD)
Entity type:Individual
Prefix:
First Name:FERHAN
Middle Name:CHESTER
Last Name:NORTH
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:F
Other - Middle Name:CHESTER
Other - Last Name:NORTH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:PO BOX 19607
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97280-0607
Mailing Address - Country:US
Mailing Address - Phone:503-245-1339
Mailing Address - Fax:
Practice Address - Street 1:420 NE MASON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97211-3479
Practice Address - Country:US
Practice Address - Phone:503-546-9413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD13100207R00000X
WAMD00028205207R00000X
ARC-5943207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C94462Medicare UPIN