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Individual

MRS. KATIA LEASE SHORB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
619 NW 6TH AVE FL 2, PORTLAND, OR 97209-3964
(503) 988-3700
Mailing address
619 NW 6TH AVE FL 5, PORTLAND, OR 97209-3964

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
200550120NP
OR

Other

Enumeration date
02/06/2007
Last updated
11/26/2019
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