Individual
DONITA ZOE DIAMATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10150 SE ANKENY ST STE 201A, PORTLAND, OR 97216-2369
(503) 922-2377
(503) 922-2360
Mailing address
10150 SE ANKENY ST STE 201A, PORTLAND, OR 97216-2369
(503) 922-2377
(503) 922-2360
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
—
—
372600000X
Adult Companion
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124288840
OPTUM
OR
Enumeration date
06/16/2008
Last updated
01/17/2014
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