Individual
DR. ANGELA KALISIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
265 N BROADWAY ST, PORTLAND, OR 97227-1800
(503) 280-1223
(503) 528-5252
Mailing address
265 N BROADWAY ST, PORTLAND, OR 97227-1800
(503) 280-1223
(503) 528-5252
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
MD17578
OR
207RH0003X
Hematology & Oncology Physician
MD17578
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040886
—
OR
05
—
1009145
—
WA
Enumeration date
05/24/2005
Last updated
02/23/2011
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