Individual
BETH ALISON CARDWELL
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) 418-5700
Mailing address
4836 SW FAIRHAVEN DR, PORTLAND, OR 97221-2616
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD19611
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149986
—
OR
Enumeration date
07/31/2006
Last updated
07/08/2007
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