MEDICARE: DR. AVIVA ZIGMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	MD23025	OR
2	207P00000X	Emergency Medicine Physician	MD23025	OR
3	207P00000X	Emergency Medicine Physician	MD00044976	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00301890	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	858543002	OTHER	REGENCE BC/BS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013970060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AVIVA ZIGMAN MD

Provider Business Mailing Address
First Line	:	1150 NW QUIMBY ST UNIT 1404
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97209-2491
Country	:	US
Telephone Number	:	503-516-1110
Fax Number	:

Provider Business Practice Location Address
First Line	:	4560 SE INTERNATIONAL WAY STE 100
Second Line	:
City	:	MILWAUKIE
State	:	OR
Zip	:	97222-4628
Country	:	US
Telephone Number	:	971-206-5164
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	03/27/2024

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Directions to “ DR. AVIVA ZIGMAN MD” Practice Location

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