Provider Demographics
NPI:1477643443
Name:FRIEND, SEAN MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:MICHAEL
Last Name:FRIEND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:5635 NE ALAMEDA ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-3421
Mailing Address - Country:US
Mailing Address - Phone:503-282-0979
Mailing Address - Fax:503-288-7803
Practice Address - Street 1:5635 NE ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-3421
Practice Address - Country:US
Practice Address - Phone:503-282-0979
Practice Address - Fax:503-288-7803
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OROR19915207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORG49594Medicare UPIN