Individual
AUDREY A CRIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
19500 SE STARK ST, PORTLAND, OR 97233-5757
(503) 669-3900
Mailing address
325 NE 63RD AVE, PORTLAND, OR 97213-5003
(503) 756-0552
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD26457
OR
Other
Enumeration date
09/06/2006
Last updated
02/04/2008
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