Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD25855 | OR |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD60813558 | WA |
NPI | 1346255833 |
---|---|
Provider Name | Mary Anna Denman |
First Address | Portland, OR 97232-2686 |
Second Address | Portland, OR 97225-6634 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 18/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
269889 | (05) | OR |
I42912 | (02) |