| William M Bennett, MD | |
|
1040 Nw 22nd Ave, Suite 480, Portland, OR 97210 | |
| (503) 413-6555 | |
| (503) 413-6563 |
| Full Name | William M Bennett |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine - Nephrology |
| Location | 1040 Nw 22nd Ave, Portland, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457320525 | NPI | - | NPPES |
| 8159055 | Medicaid | WA | |
| 042044 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RN0300X | Internal Medicine - Nephrology | 07668 (Oregon) | Primary |
| 207RN0300X | Internal Medicine - Nephrology | 09973 (Washington) | Secondary |
| Entity Name | Legacy Good Samaritan Hospital And Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780608216 PECOS PAC ID: 0547179939 Enrollment ID: O20031125000416 |
| Mailing Address | Practice Location Address |
|---|---|
| William M Bennett, MD 1040 Nw 22nd Ave, Suite 480, Portland, OR 97210 Ph: (503) 413-6555 | William M Bennett, MD 1040 Nw 22nd Ave, Suite 480, Portland, OR 97210 Ph: (503) 413-6555 |
Salona Shrestha, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 4805 Ne Glisan St, Portland, OR 97213 Phone: 503-215-2392 | |
Dr. Emmanuel Trungtoan Tavan, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 2800 N Vancouver Ave, Suite 230, Portland, OR 97227 Phone: 503-413-2901 | |
Ginevra Lois Liptan, M.D. Nephrology Medicare: Not Enrolled in Medicare Practice Location: 6400 Sw Canyon Ct, Ste 100, Portland, OR 97221 Phone: 503-477-9616 Fax: 503-477-9808 | |
Donald Richard Sullivan, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 3181 Sw Sam Jackson Park Rd, Uhn67, Portland, OR 97239 Phone: 503-494-6949 | |
Dr. Victor Nguyen Pham, M.D. Nephrology Medicare: Accepting Medicare Assignments Practice Location: 9205 Sw Barnes Rd, Portland, OR 97225 Phone: 503-216-2906 | |
Richa Uppal, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 1849 Nw Kearney St Ste 200, Portland, OR 97209 Phone: 971-229-4545 Fax: 503-966-2427 | |
Reem Hasan, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 3181 Sw Sam Jackson Park Rd, Ppv 350, Portland, OR 97239 Phone: 503-494-8562 |