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Individual

DR. ALFREDO JOSE SOTO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
182 SW ACADEMY ST, SUITE 30, DALLAS, OR 97338-1922
(503) 623-9289
(503) 831-1726
Mailing address
17695 OCEAN BLVD, ROCKAWAY BEACH, OR 97136-9689
(503) 548-7363

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301505995
MI
2084P0800X
Psychiatry Physician
MD21696
OR
2084P0804X
Child & Adolescent Psychiatry Physician
MD21696
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
122564
OR
01
2019036194
STATE MEDICAL LICENSE
MO
01
MD21696
STATE MEDICAL LICENSE
OR
Enumeration date
08/29/2006
Last updated
03/07/2023
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