Individual
GERALDINE PIERCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1207 SE 113TH AVE, PORTLAND, OR 97216-3525
(503) 253-7675
Mailing address
1207 SE 113TH AVE, PORTLAND, OR 97216-3525
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
7367
OR
Other
Enumeration date
06/22/2009
Last updated
06/22/2009
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