Individual
MARIE LOUISE DHULST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
800 SW 13TH AVE, PORTLAND, OR 97205
(503) 221-0161
(503) 274-1697
Mailing address
800 SW 13TH AVE, PORTLAND, OR 97205
(503) 221-0161
(503) 274-1697
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD20104
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151346
—
OR
Enumeration date
11/29/2006
Last updated
11/06/2020
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