IndividualActive
Bryan Petersen, MD
NPI 1740296292 · Vascular & Interventional Radiology Physician · Portland, OR
Provider details
- NPI number
- 1740296292
- Entity type
- Individual
- Primary specialty
- Vascular & Interventional Radiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- MD15285 (OR)
Practice location
3181 Sw Sam Jackson Park Rd
Portland, OR 97239-3011
Phone: (503) 494-7660
Mailing address
14930 Nw Gillihan Rd
Portland, OR 97231-1519
Registry dates
- Enumerated
- 2006-08-01
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.