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Individual

DR. ILMAR SOOT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11782 SW BARNES RD, STE 300, PORTLAND, OR 97225-5914
(503) 214-5200
(503) 906-6613
Mailing address
11782 SW BARNES RD, STE 300, PORTLAND, OR 97225-5914
(503) 214-5200
(503) 906-6613

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
07178
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
181263
OR
Enumeration date
07/23/2006
Last updated
07/09/2007
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