Individual
TIFFANY KORF - MILBOURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3241 NE BROADWAY ST, PORTLAND, OR 97232-1814
(503) 555-9656
Mailing address
3241 NE BROADWAY ST, PORTLAND, OR 97232-1814
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
18609
OR
Other
Enumeration date
07/23/2014
Last updated
12/07/2020
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