Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ANDREA PROKOP, MD
DeactivatedANDREA PROKOP, MD is a Internal Medicine healthcare provider located in PORTLAND, Oregon. NPI 1760910558 is deactivated in the NPPES registry. Verify at CMS.
Internal Medicine · PORTLAND, OR
This NPI has been deactivated.
The record was deactivated on December 28, 2017.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1760910558
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- May 24, 2017 (0.5972602739726 yrs)
- Last Updated
- Sep 7, 2021
- Deactivated
- Dec 28, 2017
- License
-
MD61055460 (WA)
Practice Information
- Address
-
1200 NW 23RD AVENUELEGACY CLINIC GOOD SAMARITANPORTLAND, OR, 97210Browse OR providers · Browse ZIP 97210
- Phone
- 5034137074
- Fax
- 5034136393
- Primary Specialty
-
Internal Medicine
207R00000X
- Additional Specialty
- Internal Medicine
Other Internal Medicine Providers in PORTLAND, OR
| Name | Credential | NPI |
|---|---|---|
| DR. ELISE JAN FULSANG | MD | 1952305385 |
| TIMOTHY S CLEARY | M.D. | 1215933411 |
| ANDRIS ANTONISKIS | MD | 1528067972 |
| RHONDA C TIERNEY | M.D. | 1447250360 |
| THOMAS G GRAGNOLA | MD | 1144220765 |
| MARCIA M KERENSKY | MD | 1053311670 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.