Provider Demographics
NPI:1306103338
Name:DIARRA, ADAMA (DO)
Entity type:Individual
Prefix:DR
First Name:ADAMA
Middle Name:
Last Name:DIARRA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7001 SW HAMPTON STREET
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:OR
Mailing Address - Zip Code:97223
Mailing Address - Country:US
Mailing Address - Phone:503-664-1207
Mailing Address - Fax:503-664-1232
Practice Address - Street 1:7001 SW HAMPTON STREET
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223
Practice Address - Country:US
Practice Address - Phone:503-664-1207
Practice Address - Fax:503-664-1232
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-16
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A23030207R00000X
WA61611275207R00000X
ORDO169455207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty