Individual
DR. ANNETTE MELIZA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, CSB-550, PORTLAND, OR 97239-3011
(503) 494-7551
Mailing address
921 N STAFFORD ST, PORTLAND, OR 97217-1367
(503) 494-0720
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD156983
OR
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
MD156983
OR
Other
Enumeration date
06/25/2008
Last updated
06/09/2014
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