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General NPI Number Information
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NPI Number | 1184067076
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Entity Type | Individual
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Provider Name | EMILY AMOS EDWARDS MD
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Gender | Female
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Dates
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Enumeration Date | 04/10/2013
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Last Update Date | 07/22/2019
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Provider Practice Location Address
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Address Line | 3181 SW SAM JACKSON PARK RD
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City | PORTLAND
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State | OR
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Zip | 97239-3098
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Country | US
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Telephone | 503-494-8311
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Fax |
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Provider Business Mailing Address
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Address Line | 3720 SW BOND AVE UNIT 2118
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City | PORTLAND
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State | OR
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Zip | 97239-4577
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Country | US
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Telephone | 206-818-6121
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Fax |
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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 | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | MD193001
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License Number State | OR
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