Individual
MRS. NITZA QUILES SOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9555 SW BARNES RD, #270, PORTLAND, OR 97225
(503) 297-1025
(503) 297-1043
Mailing address
9555 SW BARNES RD, #270, PORTLAND, OR 97225
(503) 297-1025
(503) 297-1043
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD 12560
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021993010
BLUE CROSS
OR
05
—
135230
—
OR
01
—
931129829A009
TRICARE
OR
01
—
E87104
PHP
OR
Enumeration date
02/05/2007
Last updated
02/27/2012
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