Individual
MIRANDA C MCCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2935 SW CEDAR HILLS BLVD, BEAVERTON, OR 97005-1342
(503) 352-6000
Mailing address
PO BOX 568, CORNELIUS, OR 97113-0568
(503) 359-5564
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD25709
OR
Other
Enumeration date
05/26/2006
Last updated
07/08/2007
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