Organization
WILLAMETTE MEDICAL LABS, INC.
Active
Other names
Aesthetic Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY DARM MD (PRESIDENT)
(503) 697-9777
Entity
Organization
Contact information
Practice address
9735 SW SHADY LN STE 203, TIGARD, OR 97223-5481
(503) 697-9777
(503) 597-3708
Mailing address
9735 SW SHADY LN STE 203, TIGARD, OR 97223-5481
(503) 697-9777
(503) 597-3708
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD10790
OR
Other
Enumeration date
01/13/2010
Last updated
01/13/2010
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