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STEVEN LLOYD PRIMACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 418-0990
Mailing address
6625 SE 31ST AVE, PORTLAND, OR 97202-8629

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD18737
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
064076
OR
Enumeration date
08/03/2006
Last updated
08/08/2011
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