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MIRIAM AGISIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
8935 SE POWELL BLVD, PORTLAND, OR 97266-1938
(503) 772-4335
(503) 772-4337
Mailing address
8935 SE POWELL BLVD, PORTLAND, OR 97266-1938
(503) 772-4335
(503) 772-4337

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD179807
OR
207Q00000X
Family Medicine Physician
MT204726
PA

Other

Enumeration date
06/04/2013
Last updated
10/05/2016
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