Organization
GRAPEVINE WOMENS HEALTH AND GYNECOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLA ROTBERG MD (MANAGER)
(503) 781-8846
Entity
Organization
Contact information
Practice address
5880 NE CORNELL RD STE C, HILLSBORO, OR 97124-9075
(503) 781-8846
Mailing address
13124 NW OLD GERMANTOWN RD, PORTLAND, OR 97231-2711
(503) 781-8846
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
23173
OR
Other
Enumeration date
05/30/2013
Last updated
06/05/2013
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