Individual
MRS. DEANNA G MIDDLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
4805 NE GLISAN ST, PORTLAND, OR 97213-2933
(503) 215-6059
Mailing address
16023 NW RAMONA DR, BEAVERTON, OR 97006-7737
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
99516
OR
Other
Enumeration date
05/23/2007
Last updated
07/08/2007
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