MARCO COLASURDO
Individual Provider (NPI-1)
Active
Provider Information
- NPI Number
1992392179- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 3181 SW SAM JACKSON PARK RD, PORTLAND, OR, 972393042
- Phone
- (503) 494-7660
- Fax
- (503) 494-4258
Specialties & Taxonomies
Unknown
License: TX #BP10070245
Unknown
Primary License: OR #MF214492