Individual
MIRIAM SHARON ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4060 SW 110TH AVE, BEAVERTON, OR 97005-3017
(503) 819-1215
Mailing address
4060 SW 110TH AVE, BEAVERTON, OR 97005-3017
(503) 819-1215
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
MD27475
OR
208D00000X
General Practice Physician
MD27475
OR
Other
Enumeration date
12/16/2009
Last updated
07/31/2012
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