Miranda Mccormack, M.d., LLC

NPI #1043488166 in Beaverton, Oregon

Provider Information

NPI Number: 1043488166
Entity Type: Organization
Organization Name: Miranda Mccormack, M.d., LLC
Primary Specialty: Clinic/Center - Primary Care
Enumeration Date: Feb 11, 2008
Last Updated: Feb 11, 2008

Practice Location

Address: 5040 SW GRIFFITH DR
Address 2: #201
City: Beaverton
State: Oregon
ZIP Code: 97005-2985
Phone: (503) 616-2224

Authorized Official

Name: DR. MIRANDA CHRISTIE MCCORMACK, M.D.
Title: PHYSICIAN/OWNER
Phone: (503) 616-2224

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Primary Care — Primary Care	261QP2300X	Primary

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