Individual
DIKLAH OREVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2065 NE TUCSON WAY APT 110, BEND, OR 97701-5182
(541) 383-3005
(541) 383-1883
Mailing address
PO BOX 4228, PORTLAND, OR 97208-4228
(541) 383-3005
(541) 383-1883
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA158116
OR
363AS0400X
Surgical Physician Assistant
22099
CA
Other
Enumeration date
04/26/2012
Last updated
07/25/2024
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