Individual
IONELA CIMPAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3500 NE MLK BLVD STE 200, PORTLAND, OR 97212-2093
(503) 233-5405
Mailing address
11255 SW 79TH AVE, TIGARD, OR 97223-8736
(503) 984-4569
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000WDBCH
GROUP MEDICARE
OR
01
—
0000WDBCH
GROUP MEDICARE
WA
05
—
164936
—
OR
Enumeration date
09/24/2014
Last updated
09/24/2014
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