Individual
LAURA OSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
17332 SE POWELL BLVD, PORTLAND, OR 97236-1648
(503) 415-4110
Mailing address
PO BOX 278, WOODBURN, OR 97071-0278
(971) 983-5260
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
161106
OR
Other
Enumeration date
07/22/2010
Last updated
05/18/2017
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