Individual
DR. DIEGO F DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4920 N INTERSTATE AVE, PORTLAND, OR 97217-3653
(503) 215-3300
(503) 215-3350
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11014152A
IN
207Q00000X
Family Medicine Physician
Primary
MD159017
OR
207QS0010X
Sports Medicine (Family Medicine) Physician
MD159017
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500649902
—
OR
Enumeration date
07/09/2008
Last updated
02/04/2022
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