| Diana S Domnitei Md Llc | |
|
1012 Sw King Ave Ste 306 Portland OR 97205-1110 | |
| (503) 467-8763 | |
| Not Available |
| Full Name | Diana S Domnitei Md Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1012 Sw King Ave Ste 306, Portland, Oregon |
| Authorized Official Name and Position | Diana Sidonia Domnitei (MEMBER) |
| Authorized Official Contact | 5034678763 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diana S Domnitei Md Llc 1012 Sw King Ave Ste 306 Portland OR 97205-1110 Ph: () - | Diana S Domnitei Md Llc 1012 Sw King Ave Ste 306 Portland OR 97205-1110 Ph: (503) 467-8763 |
| NPI Number | 1538601737 |
|---|---|
| Provider Enumeration Date | 11/06/2016 |
| Last Update Date | 11/06/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538601737 | NPI | - | NPPES |
| 1639361868 | Other | OR | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | MD155672 (Oregon) | Primary |
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