Individual
IMELDA P LACAYANGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9427 SW BARNES RD, SUITE 396, PORTLAND, OR 97225-6652
(503) 216-6550
(503) 216-6575
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD19170
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067546
—
OR
Enumeration date
06/23/2006
Last updated
10/02/2020
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