Individual
BARBARA DE LATORRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
16180 SE SUNNYSIDE RD, STE 102, CLACKAMAS, OR 97015-6302
(503) 513-8930
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
Primary
MD29214
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500634333
—
OR
Enumeration date
06/10/2009
Last updated
05/31/2012
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