SOROUSH AMALI
Individual Provider (NPI-1)
Active
Dentist, General Practice
Provider Information
- NPI Number
1861846578- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 7201 N INTERSTATE AVE, PORTLAND, OR, 972175523
- Phone
- (503) 286-6868
Specialties & Taxonomies
Student in an Organized Health Care Education/Training Program
Dentist, General Practice
Primary License: OR #D10530
All Addresses
MAILING
2730 SW MOODY AVE
PORTLAND, OR, 972015042