Individual
DR. NIR MODIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
3303 SW BOND AVENUE,, MAILCODE CH6D OHSU - DIGESTIVE HEALTH CENTER, PORTLAND, OR 97239
(503) 494-4373
Mailing address
3181 SW SAM JACKSON PARK ROAD, OHSU MAILCODE #L-461, PORTLAND, OR 97239-3098
(503) 494-4373
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A96835
CA
207RG0100X
Gastroenterology Physician
Primary
MD157584
OR
Other
Enumeration date
01/24/2008
Last updated
12/19/2012
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