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NPI Code Detail

MEDICARE: DR. IRINA ROZIN CASSIMATIS M.D.

MEDICARE: DR. IRINA ROZIN CASSIMATIS M.D.
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
1207V00000XObstetrics & Gynecology PhysicianMD61270523WA
2207VM0101XMaternal & Fetal Medicine PhysicianMD209836OR

General Provider Information

NPI Number : 1194119172
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IRINA ROZIN CASSIMATIS M.D.
Provider Business Mailing Address
First Line : 3181 SW SAM JACKSON PARK RD # L466
Second Line :
City : PORTLAND
State : OR
Zip : 97239-3098
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3181 SW SAM JACKSON PARK RD # L466
Second Line :
City : PORTLAND
State : OR
Zip : 97239-3011
Country : US
Telephone Number : 503-494-2101
Fax Number : 503-494-5296
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2015
Last Update Date : 09/15/2022

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