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Individual

DEBRA LAUREN DIAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
300 PASTEUR DR RM HC 133, STANFORD, CA 94305-2200
(650) 725-5078
Mailing address
1650 NW NAITO PKWY, STE 185, PORTLAND, OR 97209-2535
(503) 525-7694

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
54422
CA
363A00000X
Physician Assistant
Primary
PA189344
OR

Other

Enumeration date
06/23/2014
Last updated
07/21/2022
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