Provider Demographics
NPI:1548496573
Name:ZIMMER, ALEXANDRA DOS SANTOS (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:DOS SANTOS
Last Name:ZIMMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3191 SW SAM JACKSON PARK ROAD
Mailing Address - Street 2:MAIL CODE: OC14HO
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3011
Mailing Address - Country:US
Mailing Address - Phone:503-494-9160
Mailing Address - Fax:
Practice Address - Street 1:3191 SW SAM JACKSON PARK ROAD,
Practice Address - Street 2:MAIL CODE: OC14HO
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-9723
Practice Address - Country:US
Practice Address - Phone:503-494-9160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-04
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD211105207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology