Individual
TINA L VAVRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
9290 SE SUNNYBROOK BLVD STE 120, CLACKAMAS, OR 97015-6802
(503) 215-2110
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
DO167186
CT
208000000X
Pediatrics Physician
Primary
DO167186
OR
Other
Enumeration date
05/23/2011
Last updated
11/30/2021
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