Individual
MS. VIRGINIA ADELAIDE SIMONIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4265 SE 116TH AVE, PORTLAND, OR 97266-2109
(503) 760-2509
Mailing address
4265 SE 116TH AVE, PORTLAND, OR 97266-2109
(503) 760-2509
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
2186
OR
Other
Enumeration date
11/17/2008
Last updated
11/17/2008
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