SOROUSH AMALI

PORTLAND, OR
NPI1861846578
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: OR  D10530)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2016-04-19
Last Update Date2020-11-02
Business Address
SOROUSH AMALI
7201 N INTERSTATE AVE
PORTLAND, OR 97217-5523
Phone number: 503-286-6868
Mailing Address
SOROUSH AMALI
2730 SW MOODY AVE
PORTLAND, OR 97201-5042
Phone number: