Individual
CORY AMANDA DONOVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1040 NW 22ND AVE STE 560, PORTLAND, OR 97210-3097
(503) 413-5525
(503) 413-5526
Mailing address
3701 WILSHIRE BOULEVARD, SUITE 600, LOS ANGELES, CA 90010-4041
(323) 361-3550
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD60729370
WA
2086X0206X
Surgical Oncology Physician
MD181298
OR
Other
Enumeration date
05/31/2009
Last updated
08/05/2021
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