Individual
PETRA S NIEMANN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10150 SE 32ND AVE, MILWAUKIE, OR 97222-6516
(503) 513-8336
(503) 513-8191
Mailing address
PO BOX 3349, PORTLAND, OR 97208-3349
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD25428
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272010
—
OR
Enumeration date
05/26/2006
Last updated
07/08/2007
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