Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | MD166290 | OR |
NPI | 1912982463 |
---|---|
Provider Name | Dr. Sandra Iragorri Iragorri |
First Address | Portland, OR 97239-3011 |
Second Address | New Haven, CT 06510-3220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2005 |
Last Update Date | 18/12/2015 |