Individual
DR. A P AVERSANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
9200 SE 91ST AVE, PORTLAND, OR 97266-6756
(509) 837-4366
(509) 837-4344
Mailing address
PO BOX 2053, LAKE OSWEGO, OR 97035-0632
(509) 837-4366
(509) 837-4344
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
DO10193
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
232405
—
OR
Enumeration date
01/06/2007
Last updated
07/08/2007
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