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Individual

OTUODITA E EJIASA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
728 MOLALLA AVE, OREGON CITY, OR 97045-2799
(503) 656-9030
(503) 656-9026
Mailing address
7320 SW HUNZIKER RD STE 300, PORTLAND, OR 97223-2302
(503) 941-3077

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD156940
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500652138
OR
Enumeration date
04/06/2009
Last updated
08/04/2020
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