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1013918978
BERT G TAVELLI
PORTLAND, OR
NPI
1013918978
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207N00000X Dermatology
(Licence: OR MD 14681)
Enumeration Date
2005-08-02
Last Update Date
2023-03-07
Business Address
BERT G TAVELLI MD
2525 NW LOVEJOY ST STE 400
PORTLAND, OR 97210-2865
Phone number: 503-223-1933
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Mailing Address
BERT G TAVELLI MD
2525 NW LOVEJOY ST STE 400
PORTLAND, OR 97210-2865
Phone number: 503-223-1933
Copy
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