Individual
DR. LYNETTE SANTOS MALIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3600 N INTERSTATE AVE, DEPARTMENT OF PHYSICAL MEDICINE, PORTLAND, OR 97227-1106
(503) 331-3070
(503) 331-3089
Mailing address
3600 N INTERSTATE AVE, DEPARTMENT OF PHYSICAL MEDICINE, PORTLAND, OR 97227-1106
(503) 331-3070
(503) 331-3089
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
125053433
IL
208100000X
Physical Medicine & Rehabilitation Physician
2011033713
MO
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
MD163117
OR
Other
Enumeration date
08/07/2007
Last updated
11/13/2013
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