Individual
MAHTAB NIYYATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3515 SW BARBUR BLVD APT X1, PORTLAND, OR 97239-4155
(508) 340-6145
Mailing address
3515 SW BARBUR BLVD APT X1, PORTLAND, OR 97239-4155
(508) 340-6145
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
225724
MA
Other
Enumeration date
05/15/2008
Last updated
05/15/2008
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