Individual
DR. MARY LYNN SORENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, L611, PORTLAND, OR 97239-3011
(503) 494-6518
(503) 494-6519
Mailing address
9220 SW BARBUR BLVD, SUITE 119-196, PORTLAND, OR 97219-5428
(503) 708-9804
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD158087
OR
2086S0102X
Surgical Critical Care Physician
MD158087
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FE155732
OREGON MEDICAL LICENSE
OR
01
—
LL15240
OREGON MEDICAL LICENSE
OR
01
—
LL16084
OREGON MEDICAL LICENSE
OR
01
—
LL17317
OREGAN BOARD OF MEDICAL E
OR
01
—
LL17711
OREGON MEDICAL LICENSE
OR
01
—
LL18719
OREGON MEDICAL LICENSE
OR
01
—
MD158087
OREGON MEDICAL LICENSE
OR
01
—
PG152564
OREGON MEDICAL LICENSE
OR
Enumeration date
07/18/2007
Last updated
06/27/2012
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