Individual
JANETTE L GREEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9155 SW BARNES RD, SUITE 340, PORTLAND, OR 97225-6625
(503) 595-4402
Mailing address
3295 NW 147TH PL, PORTLAND, OR 97229-0908
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD18257
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
071584
—
OR
Enumeration date
11/02/2005
Last updated
07/08/2007
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