Costantino, Mary Marcelle

Costantino, Mary Marcelle is an individual health care provider with primary practice located at 6958 Sw Varns St , Portland OR 97223-0000. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is her primary health care specialty. Costantino, Mary Marcelle can be contacted via phone (503) 683-7730.

Contact Information

Primary practice address
6958 Sw Varns St Portland OR 97223-0000
Phone: (503) 683-7730
Fax: (503) 914-0927
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD26429 Oregon
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X MD26429 Oregon

Profile Details

NPI number 1407951171
LBN Legal business name Costantino, Mary Marcelle
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2006
Last updated Jan 26th, 2022 - about 2 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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