Provider Demographics
NPI:1366933830
Name:DR FRANCES V VERZOSA MD PC
Entity type:Organization
Organization Name:DR FRANCES V VERZOSA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL ASSISTANT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:VERZOSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-226-3579
Mailing Address - Street 1:12770 SE STARK ST BLDG C
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97233-1539
Mailing Address - Country:US
Mailing Address - Phone:503-226-3579
Mailing Address - Fax:503-525-5875
Practice Address - Street 1:12770 SE STARK ST BLDG C
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97233-1539
Practice Address - Country:US
Practice Address - Phone:503-226-3579
Practice Address - Fax:503-525-5875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center