Pine, Diedra M

Pine, Diedra M is an individual health care provider with primary practice located at 1675 Sw Marlow Ave Ste 200 , Portland OR 97225-5102. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Pine, Diedra M can be contacted via phone (503) 802-5261.

Contact Information

Primary practice address
1675 Sw Marlow Ave Ste 200 Portland OR 97225-5102
Phone: (503) 802-5261
Fax: (503) 905-6159
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X 01060048 Oregon

Profile Details

NPI number 1942321104
LBN Legal business name Pine, Diedra M
Credentials MOT
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 3rd, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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