NIKITA S IVANOV

PORTLAND, OR
NPI1912648353
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2022-04-06
Last Update Date2023-04-19
Business Address
Dr. NIKITA S IVANOV MD
1015 NW 22ND AVE
PORTLAND, OR 97210-3025
Phone number: 503-413-8401
Mailing Address
Dr. NIKITA S IVANOV MD
1015 NW 22ND AVE
PORTLAND, OR 97210-3025
Phone number: 503-200-8758
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