Individual
SIMONE LOUISE VANSWAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3550 N INTERSTATE AVE, PORTLAND, OR 97227-1196
(800) 813-2000
Mailing address
500 NE MULTNOMAH ST STE 100, PORTLAND, OR 97232-2031
(800) 813-2000
(855) 524-5255
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD154636
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500638407
—
OR
01
—
R161610
MEDICARE PTAN
OR
Enumeration date
03/29/2007
Last updated
06/27/2025
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