Individual
MANIA KUPERSHTOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1175 MOUNT HOOD AVE, WOODBURN, OR 97071-9060
(503) 982-2000
(503) 982-0660
Mailing address
1175 MOUNT HOOD AVE, WOODBURN, OR 97071-9060
(503) 982-2000
(503) 982-0660
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD193501
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/16/2015
Last updated
03/18/2021
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