Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | DO198502 | OR |
NPI | 1164876827 |
---|---|
Provider Name | Diana Denton Zellner |
First Address | Portland, OR 97208-3777 |
Second Address | Portland, OR 97210-3025 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2016 |
Last Update Date | 24/07/2020 |