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Individual

MISS MIRANDA ELIZABETH MERRILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8311
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8311

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD195980
OR
207RC0000X
Cardiovascular Disease Physician
MD195980
OR
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
MD195980
OR
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
08/15/2013
Last updated
10/12/2023
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