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General NPI Number Information
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NPI Number | 1003648825
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Entity Type | Individual
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Provider Name | DINA MUQTAR
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Gender | Female
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Dates
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Enumeration Date | 08/19/2024
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Last Update Date | 08/19/2024
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Provider Practice Location Address
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Address Line | 825 NE 20TH AVE STE 320
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City | PORTLAND
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State | OR
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Zip | 97232-2275
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Country | US
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Telephone | 971-429-6321
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Fax | 503-961-7237
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Provider Business Mailing Address
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Address Line | 825 NE 20TH AVE STE 320
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City | PORTLAND
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State | OR
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Zip | 97232-2275
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Country | US
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Telephone | 971-429-6321
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Fax | 503-961-7237
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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