Individual
DR. FARAZ GHODDUSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3303 S BOND AVE, PORTLAND, OR 97239-4501
(503) 494-8573
(503) 494-3457
Mailing address
3303 S BOND AVE, PORTLAND, OR 97239-4501
(503) 494-8573
(503) 494-3457
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD209921
OR
Other
Enumeration date
05/24/2016
Last updated
08/30/2022
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