Individual
MINDY S LOEBNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5050 NE HOYT ST, SUITE 240, PORTLAND, OR 97213-2991
(503) 215-6480
(503) 215-6469
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD17108
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80044233
RR MEDICARE
OR
Enumeration date
06/24/2006
Last updated
03/19/2021
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