Individual
DMITRIY FLATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4101 NE DIVISION ST, GRESHAM, OR 97030-4617
(971) 344-6987
Mailing address
4101 NE DIVISION STREET, GRESHAM OR 97030, GRESHAM, OR 97030
(971) 344-6987
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201908396RN
OR
Other
Enumeration date
12/23/2019
Last updated
12/23/2019
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