LIPIRA B ANGELO - NPI: 1891019428


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NPI: 1891019428
Entity Type: Person: individual human being who furnishes health care.
Provider First Name: ANGELO
Provider Last Name: LIPIRA
Provider Middle Name: B
Provider Name Prefix Text: DR.
Provider Gender Code: M
Provider Credential Text: M.D.
Provider Enumeration Date: 03/25/2010
Last Update Date: 03/02/2018

Business Address:

Provider First Line Business Mailing Address: 3303 SW BOND AVE STE 5
Provider Business Mailing Address City Name: PORTLAND
Provider Business Mailing Address State Name: OR
Provider Business Mailing Address Postal Code: 97239
Provider Business Mailing Address Country Code (If outside U.S.): US
Phone: 5034946687
Fax Number: 5034941717

Mailing Address:

Provider First Line Business Practice Location Address: 3303 SW BOND AVE STE 5
Provider Business Practice Location Address City Name: PORTLAND
Provider Business Practice Location Address State Name: OR
Provider Business Practice Location Address Postal Code: 97239
Provider Business Practice Location Address Country Code (If outside U.S.): US
Phone: 5034946687
Fax Number: 5034941717

Primary Taxonomy:

Taxonomy Code: 208200000X
License Number: MD60292214
License State: WA
Healthcare Provider Primary Taxonomy Switch: N - The taxonomy is not the primary taxonomy
Type: Allopathic & Osteopathic Physicians
Classification: Plastic Surgery
Definition: A plastic surgeon deals with the repair
Taxonomy Description: reconstruction or replacement of physical defects of form or function involving the skin

Secondary Taxonomy:

Taxonomy Code: 208200000X
License Number: MD182026
License State: OR
Healthcare Provider Primary Taxonomy Switch: Y - The taxonomy is the primary taxonomy (there can be only one per NPI record
Type: Allopathic & Osteopathic Physicians
Classification: Plastic Surgery
Definition: A plastic surgeon deals with the repair
Taxonomy Description: reconstruction or replacement of physical defects of form or function involving the skin
Source: The National Provider Identifier

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