Healthcare Provider Details

I. General information

NPI: 1548307028
Provider Name (Legal Business Name): LAURA HOPE GREENBERG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9155 SW BARNES RD SUITE 320
PORTLAND OR
97225-6625
US

IV. Provider business mailing address

9155 SW BARNES RD SUITE 320
PORTLAND OR
97225-6625
US

V. Phone/Fax

Practice location:
  • Phone: 503-292-4453
  • Fax: 503-292-2321
Mailing address:
  • Phone: 503-292-4453
  • Fax: 503-292-2321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberOSL15292
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: