Individual
MIKAELA LEA RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8211
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3098
(503) 494-6176
(503) 494-6152
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD19950
OR
Other
Enumeration date
04/11/2016
Last updated
06/23/2020
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