Individual
LOURDES QUINTANILLA-DIECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-5674
(503) 494-4631
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-5674
(503) 494-4631
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD173369
OR
207YP0228X
Pediatric Otolaryngology Physician
MD173369
OR
Other
Enumeration date
05/19/2009
Last updated
05/18/2023
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