MEDICARE: CHRISTY PEREL COSS M.D.

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	208000000X	Pediatrics Physician	MD151007	OR

General Provider Information

NPI Number	:	1164452306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTY PEREL COSS M.D.

Provider Business Mailing Address
First Line	:	2875 NW STUCKI AVE
Second Line	:
City	:	HILLSBORO
State	:	OR
Zip	:	97124-5806
Country	:	US
Telephone Number	:	503-813-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2875 NW STUCKI AVE
Second Line	:
City	:	HILLSBORO
State	:	OR
Zip	:	97124-5806
Country	:	US
Telephone Number	:	503-813-2000
Fax Number	:

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

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	02/04/2022

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