Individual
KRISTINA MARIE PRUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3131 N VANCOUVER AVE, PORTLAND, OR 97227-1596
(503) 528-5920
Mailing address
3131 N VANCOUVER AVE, PORTLAND, OR 97227-1596
(503) 528-5920
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
Primary
MD206562
OR
2080P0207X
Pediatric Hematology & Oncology Physician
MD206562
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/14/2014
Last updated
08/24/2021
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