MEDICARE: TZIPORA KIRSCHNER CPM, DEM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	176B00000X	Midwife	DEM-LD-10152060	OR

General Provider Information

NPI Number	:	1013261502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TZIPORA KIRSCHNER CPM, DEM

Provider Business Mailing Address
First Line	:	8845 NE RUSSELL ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97220-5357
Country	:	US
Telephone Number	:	503-504-7397
Fax Number	:

Provider Business Practice Location Address
First Line	:	8845 NE RUSSELL ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97220-5357
Country	:	US
Telephone Number	:	503-504-7397
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2012
Last Update Date	:	11/05/2012

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