Healthcare Provider Details

I. General information

NPI: 1396824785
Provider Name (Legal Business Name): ELIZABETH MADARANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2006
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2725 SW CEDAR HILLS BLVD STE 250
BEAVERTON OR
97005-1469
US

IV. Provider business mailing address

2725 SW CEDAR HILLS BLVD STE 250
BEAVERTON OR
97005-1469
US

V. Phone/Fax

Practice location:
  • Phone: 503-415-4060
  • Fax: 503-415-4061
Mailing address:
  • Phone: 916-536-3620
  • Fax: 916-536-3541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD184006
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: