Individual
LAURA PHYLLIS PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10330 SE 32ND AVE STE 205, MILWAUKIE, OR 97222-6594
(503) 513-8950
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD215279
OR
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
262749
MA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
A150677
CA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
MD215279
OR
Other
Enumeration date
04/01/2011
Last updated
11/02/2023
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