Individual
REBECCA KATE NEBORSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
18040 SW LOWER BOONES FERRY RD, SUITE 100, TIGARD, OR 97224-7258
(503) 216-0700
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD29317
OR
207Q00000X
Family Medicine Physician
ML20008600
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500611594
—
OR
01
—
P00774484
RR MEDICARE
OR
Enumeration date
09/15/2006
Last updated
07/31/2012
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