Provider Demographics
NPI:1992940613
Name:MONSON, DINELLI (MD)
Entity type:Individual
Prefix:
First Name:DINELLI
Middle Name:
Last Name:MONSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6420 SW MACADAM AVE
Mailing Address - Street 2:SUITE 218
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3507
Mailing Address - Country:US
Mailing Address - Phone:503-244-1214
Mailing Address - Fax:503-244-3013
Practice Address - Street 1:19250 SW 65TH AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-7452
Practice Address - Country:US
Practice Address - Phone:503-695-3630
Practice Address - Fax:503-692-3420
Is Sole Proprietor?:No
Enumeration Date:2008-12-09
Last Update Date:2014-05-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORLL16746207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology