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Individual

DR. ROXANA RUTH MASSEY ABBOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
15640 NW LAIDLAW RD, SUITE 102, PORTLAND, OR 97229-3828
(503) 764-0100
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO155981
OR
207Q00000X
Family Medicine Physician
OL60018342
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500638687
OR
01
P01026743
RR MEDICARE
OR
Enumeration date
07/31/2008
Last updated
07/25/2012
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