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Individual

DR. JANICE L. COCKRELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2801 N GANTENBEIN AVE, SUITE 2225, PORTLAND, OR 97227-1623
(503) 413-4505
(503) 413-4719
Mailing address
2801 N GANTENBEIN AVE, SUITE 2225, PORTLAND, OR 97227-1623
(503) 413-4505
(503) 413-4719

Taxonomy

Speciality
Code
Description
License number
State
2081P0010X
Pediatric Rehabilitation Medicine Physician
Primary
17561
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
038369
OR
Enumeration date
02/22/2006
Last updated
03/04/2011
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