Organization
MY OTHER ME
Active
Organization
MY OTHER ME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY AFSARI-HOWARD DO (FOUNDER/CEO)
(503) 522-1446
Entity
Organization
Contact information
Practice address
519 SW PARK AVE STE 304, PORTLAND, OR 97205-3204
(503) 522-1446
Mailing address
2343 SE 57TH AVE, PORTLAND, OR 97215-4005
(503) 522-1446
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5006254
—
OR
Enumeration date
05/28/2021
Last updated
03/11/2022
Update your record
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