MEDICARE: MARIA CRISTINA ISALES 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	A160479	CA
2	207ZD0900X	Dermatopathology (Pathology) Physician	A160479	CA

General Provider Information

NPI Number	:	1962897520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA CRISTINA ISALES MD

Provider Business Mailing Address
First Line	:	PO BOX 230577
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97281-0577
Country	:	US
Telephone Number	:	503-906-7300
Fax Number	:	503-245-8219

Provider Business Practice Location Address
First Line	:	2815 EASTLAKE AVE E STE 240
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98102-3086
Country	:	US
Telephone Number	:	503-906-7300
Fax Number	:

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

Provider Enumeration Date	:	03/31/2015
Last Update Date	:	06/04/2025

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