Individual
MICKI A KANTROWITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6410 NE HALSEY ST STE 300, PORTLAND, OR 97213-4759
(503) 215-2273
Mailing address
6410 NE HALSEY ST STE 300, PORTLAND, OR 97213-4759
(503) 215-2273
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101258386
VA
207Q00000X
Family Medicine Physician
D0040152
MD
207Q00000X
Family Medicine Physician
MD180886
OR
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
MD180886
OR
Other
Enumeration date
07/18/2006
Last updated
12/20/2019
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