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Individual

CODY CHLASTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3455 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-3076
(503) 494-7725
Mailing address
7020 N TYLER AVE, PORTLAND, OR 97203-4947
(615) 406-1646

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
06/23/2023
Last updated
06/23/2023
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