Provider Demographics
NPI:1356500821
Name:AFSARI-HOWARD, MARY FARIBA (DO)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:FARIBA
Last Name:AFSARI-HOWARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:FARIBA
Other - Middle Name:MARY
Other - Last Name:AFSARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:2150 NE DIVISION ST. SUITE 202
Mailing Address - Street 2:GRESHAM WOMEN'S HEALTHCARE, P.C.
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-5859
Mailing Address - Country:US
Mailing Address - Phone:503-667-4545
Mailing Address - Fax:503-666-3298
Practice Address - Street 1:519 SW PARK AVE STE 304
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-3204
Practice Address - Country:US
Practice Address - Phone:971-533-4867
Practice Address - Fax:971-206-9640
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO151332207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology