Individual
MARGARET JOANNA BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5330 NE GLISAN ST STE 100, PORTLAND, OR 97213
(503) 215-9700
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD189000
OR
Other
Enumeration date
05/17/2010
Last updated
02/15/2021
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