FARNAZ DANA FAKHARI, MD, PC
Ambulatory Health at Willamette Dr, West Linn, OR

License number
Oregon MD157343
Category
Ambulatory Health
Type
Medical Specialty
Owner
Name: FARNAZ DANA FAKHARI MD
Title: PHYSICIAN PROVIDER/PRESIDENT
Phone: (503) 344-6487
Address
Address
18380 Willamette Dr STE 201, West Linn, OR 97068
National Provider ID: 1528311123
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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FARNAZ DANA FAKHARI, MD, PC

Portland, OR  -  West Linn, OR

Industry:
Medical Doctor's Office, Nonclassifiable Establishments
Registration:
Sep 13, 2012
Addresses:
1012 SW King Ave STE 202, Portland, OR 97205 (Mailing)
18380 Willamette Dr STE 201, West Linn, OR 97068 (Physical)
State ID:
88187399
Business type:
DOMESTIC PROFESSIONAL CORPORATION
Agent:
Jonathan Dmishkin,1012 SW King Ave STE 202, Portland, OR 97205 (Physical)

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