Individual
EVELYN VILLENA MEDRANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9250 SW HALL BLVD, TIGARD, OR 97223
(503) 293-0161
(503) 452-3200
Mailing address
9250 SW HALL BLVD, TIGARD, OR 97223
(503) 293-0161
(503) 452-3200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD10667
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114918
—
OR
Enumeration date
10/02/2006
Last updated
08/06/2012
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