Individual
MIRELA GAVOJDEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12625 SW GRANT AVE., TIGARD, OR 97223
(503) 620-8425
Mailing address
12625 SW GRANT AVE, TIGARD, OR 97223-5141
(503) 620-8425
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
511807
OR
Other
Enumeration date
08/31/2016
Last updated
08/31/2016
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