Organization
PNW MANAGEMENT GROUP
Active
Other names
Advanced Vascular Centers Portland
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY M COSTANTINO MD (PHYSICIAN OWNER)
(503) 683-7730
Entity
Organization
Contact information
Practice address
6958 SW VARNS ST, PORTLAND, OR 97223-8281
(503) 683-7730
(503) 914-0927
Mailing address
6958 SW VARNS ST, PORTLAND, OR 97223-8281
(503) 683-7730
(503) 914-0927
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Enumeration date
04/13/2020
Last updated
01/26/2022
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