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Search › Oregon › 207RN0300X

Robert Provenzano, MD

NPI 1972505584 · on the registry since 2005

Practice

Address
1547 Ne 40th Ave Ste B
Portland, OR 97232
Phone
(855) 397-0197
Organisation at this address
Luxottica Of America Inc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address
5

Registry record

Primary taxonomy
207RN0300X
207RN0300X
Also registered as
207RN0300X
207RN0300X
207RN0300X
207RN0300X
207RN0300X
207RN0300X
207RN0300X
207RN0300X
207RN0300X
207RN0300X
Licence states on file
ID, MI, AZ, NC, SC, PA, FL, CO, TN, OR
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2019-11-26

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon