MARCUS CORNWALL DOPC NPI 1154514446

NPI Information

  • NPI: 1154514446
  • Provider Name: MARCUS CORNWALL, DOPC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • CLIA Number: 38D2181298
  • Address: 6542 SE LAKE RD STE 202
    MILWAUKIE, OR
    ZIP 97222
  • Phone: (503) 233-5273

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NPI Details

MARCUS CORNWALL, DOPC is a primary care clinic center in Milwaukie, OR. MARCUS CORNWALL, DOPC NPI is 1154514446. The provider is registered as an organization entity type.

The provider's business location address is:

6542 SE LAKE RD STE 202
MILWAUKIE, OR
ZIP 97222-245
Phone: (503) 233-5273
Fax: (855) 492-8902

The provider's authorized official is Marcus H Cornwall .
The authorized official title is Physician And Owner and has the following contact phone number (503) 233-5273.

The CLIA number assigned to this NPI record is 38D2181298 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/21/2007 and was last updated on 12/7/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareDO23052OREGONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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