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1659950194
MARA PETERSON
PORTLAND, OR
NPI
1659950194
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: OR PG204968)
Enumeration Date
2021-04-02
Last Update Date
2021-11-30
Business Address
MARA PETERSON MD
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3098
Phone number: 503-494-8211
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Mailing Address
MARA PETERSON MD
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3098
Phone number: 503-494-8211
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