Mary Vaandering

NPI #1992049712 in Portland, Oregon

Provider Information

NPI Number: 1992049712
Entity Type: Individual
Name: Mary Vaandering
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Enumeration Date: Nov 16, 2012
Last Updated: Nov 16, 2012

Practice Location

Address: 17221 SE DIVISION ST
Address 2: S-21
City: Portland
State: Oregon
ZIP Code: 97236-1240
Phone: (503) 760-0778

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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