Individual
MARIANA DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2730 S MOODY AVE, PORTLAND, OR 97201-5042
(503) 494-3633
Mailing address
PO BOX 31001, PASADENA, CA 91110-0001
(503) 494-3633
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA227610
OR
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/07/2024
Last updated
02/05/2026
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