Individual
MANIDA WUNGJIRANIRUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3303 S BOND AVE, PORTLAND, OR 97239-4501
(503) 494-4373
(503) 418-4189
Mailing address
3303 S BOND AVE, PORTLAND, OR 97239-4501
(503) 494-4373
(503) 418-4189
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD201355
OR
207RG0100X
Gastroenterology Physician
Primary
MD201355
OR
Other
Enumeration date
06/21/2013
Last updated
09/09/2020
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