Healthcare Provider Details

I. General information

NPI: 1053374611
Provider Name (Legal Business Name): ANN MARIE LOEFFLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANN MARIE APALSCH MD

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 04/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 N GANTENBEIN AVE
PORTLAND OR
97227-1623
US

IV. Provider business mailing address

2801 N GANTENBEIN AVE
PORTLAND OR
97227-1623
US

V. Phone/Fax

Practice location:
  • Phone: 503-413-2042
  • Fax: 503-413-2566
Mailing address:
  • Phone: 503-413-2042
  • Fax: 503-413-2566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License NumberMD24226
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD24226
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: