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Individual

VIKTORIYA MIKHAYLOVNA DIMAKU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
7689 SW CAPITOL HWY, PORTLAND, OR 97219-2475
(971) 319-3562
(877) 771-0997
Mailing address
6125 SW BOUNDARY ST, PORTLAND, OR 97221-1019
(971) 319-3499

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201703002NP-PP
OR

Other

Enumeration date
05/12/2017
Last updated
12/16/2019
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