Individual
DAVID P CIAVERELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 575-2521
(503) 389-7997
Mailing address
PO BOX 10768, PORTLAND, OR 97296-0768
(503) 575-2521
(503) 389-7997
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
DO22260
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287864
—
OR
05
—
8273336
—
WA
01
—
840126007
REGENCE BC/BS
OR
01
—
P00059728
RR MC
OR
Enumeration date
12/08/2005
Last updated
11/01/2021
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