Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD195426 | OR |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | MD195426 | OR |
NPI | 1164789079 |
---|---|
Provider Name | Dominique D Laron |
First Address | Portland, OR 97239 |
Second Address | Portland, OR 97239-3009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2012 |
Last Update Date | 13/10/2020 |