Provider Demographics
NPI:1407960834
Name:LABAR, MONA TARIG (MD)
Entity Type:Individual
Prefix:DR
First Name:MONA
Middle Name:TARIG
Last Name:LABAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13705 NE AIRPORT WAY
Mailing Address - Street 2:STE C
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-1048
Mailing Address - Country:US
Mailing Address - Phone:503-258-6851
Mailing Address - Fax:
Practice Address - Street 1:13705 NE AIRPORT WAY
Practice Address - Street 2:STE C
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-1048
Practice Address - Country:US
Practice Address - Phone:503-258-6851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00040313207ZP0102X
ORMD23662207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology