Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | MD23268 | OR |
Y | 111NI0900X | Internist | MD23268 | OR |
N | 207RA0201X | Internist - Allergy & Immunology | MD00045453 | WA |
N | 207RA0201X | Internist - Allergy & Immunology | MD23268 | OR |
NPI | 1104909936 |
---|---|
Provider Name | Colleen Amanda Finnegan |
First Address | Portland, OR 97208-3158 |
Second Address | Lake Oswego, OR 97035 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 05/10/2020 |