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General NPI Number Information
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NPI Number | 1255346771
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Entity Type | Individual
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Provider Name | DANA KOSTINER SIMPSON MD
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Gender | Female
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 501 N GRAHAM ST STE 330B
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City | PORTLAND
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State | OR
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Zip | 97227-2009
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Country | US
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Telephone | 503-944-5970
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4399
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City | PORTLAND
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State | OR
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Zip | 97208-4399
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Country | US
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Telephone |
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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 | 207SG0201X
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Taxonomy Name | Clinical Genetics (M.D.) Physician
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License Number | MD23675
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License Number State | OR
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