Kerri D Derrevere MD

NPI 1760611164 - Pediatrics - 208000000X

NPI Details
NPI 1760611164
Gender Female
Enumeration Date 07/07/2009
Last Updated 02/25/2015
Entity Type Individual
Active Over 7 years ago
Practice Location
707 SW GAINES ST
PORTLAND OR, 97239-2901, US
Phone (405) 990-8777
Fax
Business Location
707 SW GAINES ST
PORTLAND OR, 97239-2901, US
Phone (405) 990-8777
Fax
Toxanomy
Taxonomy Code 208000000X
License State Oregon
License Number MD158142
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According to our database, Kerri D Derrevere MD NPI is 1760611164, taxonomy code is 208000000X and license number is MD158142, license state is located at Oregon. Kerri D Derrevere MD physically located at 707 Sw Gaines St, Portland OR, 97239-2901. NPI Number Kerri D Derrevere MD has the Individual type.

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1760611164 NPI number is provided on an as is basis without warranty of any kind. 1760611164 is maintained by the National Plan & Provider Enumeration System. The contents of Kerri D Derrevere MD are for informational purposes only.