Provider Demographics
NPI:1376840249
Name:PATCHIN, DANIEL MARVIN (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:MARVIN
Last Name:PATCHIN
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 1:4215 SE REGNER RD
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97080-9464
Mailing Address - Country:US
Mailing Address - Phone:503-665-8500
Mailing Address - Fax:
Practice Address - Street 1:4215 SE REGNER RD
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97080-9464
Practice Address - Country:US
Practice Address - Phone:503-665-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD08718207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology