Individual
DIANA VDOVTSOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1111 NE 99TH AVE, PORTLAND, OR 97220-9442
(503) 963-2707
Mailing address
1111 NE 99TH AVE, PORTLAND, OR 97220-9442
(503) 963-2707
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
202203944RN
OR
Other
Enumeration date
05/05/2026
Last updated
05/05/2026
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