Individual
DR. AMANDA ALLAN VANDLAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5050 NE HOYT ST STE 514, PORTLAND, OR 97213-2984
(503) 488-2323
(503) 488-2340
Mailing address
541 NE 20TH AVE STE 225, PORTLAND, OR 97232-2895
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD177691
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500655908
—
OR
Enumeration date
04/14/2011
Last updated
03/27/2024
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