Organization
THE WALDORF CENTER FOR PLASTIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHLEEN A WALDORF MD (PRESIDENT, OWNER, PHYSICIAN)
(503) 646-0101
Entity
Organization
Contact information
Practice address
12400 NW CORNELL RD STE 200, PORTLAND, OR 97229-5689
(503) 646-0101
(503) 350-1420
Mailing address
12400 NW CORNELL RD STE 200, PORTLAND, OR 97229-5689
(503) 646-0101
(503) 350-1420
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060207
—
OR
Enumeration date
04/09/2007
Last updated
07/21/2022
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