Individual
MS. ALEXANDRA VERDIECK DEVLAEMINCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3303 SW BOND AVE, PORTLAND, OR 97239-4501
(503) 494-8573
(503) 494-3457
Mailing address
3303 SW BOND AVE, PORTLAND, OR 97239-4501
(503) 494-8573
(503) 494-3457
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD20728
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080156436
RR MEDICARE
OR
05
—
134090
—
OR
Enumeration date
11/29/2005
Last updated
01/26/2010
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