Individual
DR. DIANA ANTONISKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3550 N INTERSTATE AVE, PORTLAND, OR 97227-1196
(503) 249-5536
(503) 249-3447
Mailing address
18955 OLSON AVE, LAKE OSWEGO, OR 97034-7420
(503) 638-5125
(503) 249-3447
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
MD00035117
WA
207RI0200X
Infectious Disease Physician
Primary
MD17138
OR
Other
Enumeration date
08/29/2006
Last updated
02/04/2022
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