Organization
FRIDA CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINEVRA LOIS LIPTAN M.D. (MEDICAL DIRECTOR)
(503) 477-9616
Entity
Organization
Contact information
Practice address
6400 SW CANYON CT, STE 100, PORTLAND, OR 97221-1461
(503) 477-9616
(503) 477-9808
Mailing address
6400 SW CANYON CT, STE 100, PORTLAND, OR 97221-1459
(503) 477-9616
(503) 477-9808
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
28421
OR
Other
Enumeration date
10/15/2011
Last updated
10/15/2011
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