Individual
NATASHA LADANE REZVANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10100 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 652-2888
Mailing address
10100 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 652-2888
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD.615698812
WA
207Q00000X
Family Medicine Physician
Primary
MD219804
OR
Other
Enumeration date
04/03/2020
Last updated
10/21/2024
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