Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | MD22980 | OR |
N | 207RC0000X | Internist - Cardiovascular Disease | MD22980 | OR |
NPI | 1811053911 |
---|---|
Provider Name | Dr. Alicia Marie Ross |
First Address | Portland, OR 97208-3158 |
Second Address | Portland, OR 97220-9428 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2006 |
Last Update Date | 15/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
226990 | (05) | OR |
H93982 | (02) | OR |