Basic Information
Provider Information
NPI: 1225171986
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRIEDMAN
FirstName: STEVEN
MiddleName: ALAN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7650 SW BEVELAND RD STE 200
Address2:  
City: PORTLAND
State: OR
PostalCode: 972238692
CountryCode: US
TelephoneNumber: 5036013615
FaxNumber: 5036461683
Practice Location
Address1: 9701 SW BARNES RD STE 299
Address2:  
City: PORTLAND
State: OR
PostalCode: 972256689
CountryCode: US
TelephoneNumber: 5032973660
FaxNumber: 5032977637
Other Information
ProviderEnumerationDate: 02/14/2007
LastUpdateDate: 06/03/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/03/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207VM0101XMD20113ORY Allopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
207VM0101XMD00035706WAN Allopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine

No ID Information.


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