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Individual

LAURA L DAHL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
7213 SW HAZELFERN RD, TIGARD, OR 97224
(503) 214-2064
Mailing address
7213 SW HAZELFERN RD, TIGARD, OR 97224
(503) 214-2064

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD17236
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
121058
OR
Enumeration date
06/30/2005
Last updated
06/25/2019
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