Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | MD18349 | OR |
NPI | 1013974559 |
---|---|
Provider Name | Darlene J Dodson |
First Address | Portland, OR 97208-3158 |
Second Address | Portland, OR 97225-6603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 16/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
065656 | (05) | OR |
G33183 | (02) | OR |