Provider Demographics
NPI:1487720710
Name:STOELK, EUGENE M (MD)
Entity type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:M
Last Name:STOELK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19722 BELLEVUE WAY
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-2266
Mailing Address - Country:US
Mailing Address - Phone:503-227-7799
Mailing Address - Fax:503-227-5452
Practice Address - Street 1:1750 SW HARBOR WAY
Practice Address - Street 2:200
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97201-5128
Practice Address - Country:US
Practice Address - Phone:503-227-7799
Practice Address - Fax:503-227-5452
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD14983207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology