Individual
TERESA MARIE DIAMATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2330 NE SISKIYOU ST, PORTLAND, OR 97212-2471
(503) 528-0757
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
200642562RN
OR
Other
Enumeration date
10/14/2008
Last updated
10/14/2008
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