Ibsen, Laura Marie

Ibsen, Laura Marie is an individual health care provider with primary practice located at 3181 Sw Sam Jackson Park Rd Cdrcp, Portland OR 97239-3011. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, which is considered as her primary health care specialty. Ibsen, Laura Marie can be contacted via phone (503) 494-4608.

Contact Information

Primary practice address
3181 Sw Sam Jackson Park Rd Cdrcp Portland OR 97239-3011
Phone: (503) 494-4608
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X MD21171 Oregon

Profile Details

NPI number 1821003336
LBN Legal business name Ibsen, Laura Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2006
Last updated Jul 13th, 2007 - about 17 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1821003336 NPPES
Oregon MEDICAID 159050

Popular Providers