Basic Information
| Provider Information | |||||||||
| NPI: | 1710195508 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DURAN | ||||||||
| FirstName: | MARIA CRISTINA | ||||||||
| MiddleName: | CRUZ | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15950 SW MILLIKAN WAY | ||||||||
| Address2: | THE PORTLAND CLINIC | ||||||||
| City: | BEAVERTON | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970065170 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5032210161 | ||||||||
| FaxNumber: | 5032214451 | ||||||||
| Practice Location | |||||||||
| Address1: | 15950 SW MILLIKAN WAY | ||||||||
| Address2: | THE PORTLAND CLINIC | ||||||||
| City: | BEAVERTON | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970065170 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5032210161 | ||||||||
| FaxNumber: | 5032214451 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 23228 | OR | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.