Organization
MIRANDA MCCORMACK, M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIRANDA CHRISTIE MCCORMACK M.D. (PHYSICIAN/OWNER)
(503) 616-2224
Entity
Organization
Contact information
Practice address
5040 SW GRIFFITH DR, #201, BEAVERTON, OR 97005-2985
(503) 616-2224
Mailing address
5040 SW GRIFFITH DR, #201, BEAVERTON, OR 97005-2985
(503) 616-2224
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
465592-90
OR
Other
Enumeration date
02/11/2008
Last updated
02/11/2008
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