Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0106X | Orthopaedic Hand Surgeon | MD182410 | OR |
NPI | 1104058072 |
---|---|
Provider Name | Ms. Dora Anna Rendulic Storelli |
First Address | Portland, OR 97213-2983 |
Second Address | San Francisco, CA 94143-2203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2009 |
Last Update Date | 11/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
500725220 | (05) | OR |