Individual
LOUISE E SIVAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
445 E MAIN ST, HILLSBORO, OR 97123-4084
(503) 640-2757
(503) 640-9753
Mailing address
445 E MAIN ST, HILLSBORO, OR 97123-4084
(503) 640-2757
(503) 640-9753
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD125381
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21812
—
OR
05
—
500646898
—
OR
01
—
R165950
PTAN
—
Enumeration date
12/31/2009
Last updated
12/13/2012
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