Individual
DR. MICHELE RADDISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
830 NE 47TH AVE, PROVIDENCE NEURODEVELOPMENTAL CENTER FOR CHILDREN, PORTLAND, OR 97213
(503) 216-2339
Mailing address
560 MILBURN CT, LAKE OSWEGO, OR 97034-1654
(503) 697-0958
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
MD2013-0227
NM
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
MD23415
OR
Other
Enumeration date
10/17/2007
Last updated
10/05/2020
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