Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | MD24226 | OR |
NPI | 1053374611 |
---|---|
Provider Name | Ann Marie Loeffler |
First Address | Portland, OR 97227-1623 |
Second Address | Portland, OR 97227-1623 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2006 |
Last Update Date | 26/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
181981 | (05) | OR |
E55582 | (02) | OR |