Provider Demographics
NPI:1497737670
Name:KORNGOLD, ELENA KARP (MD)
Entity Type:Individual
Prefix:DR
First Name:ELENA
Middle Name:KARP
Last Name:KORNGOLD
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Gender:F
Credentials:MD
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Mailing Address - Street 1:3181 SW SAM JACKSON PARK RD
Mailing Address - Street 2:MAIL CODE L340
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3011
Mailing Address - Country:US
Mailing Address - Phone:503-494-4511
Mailing Address - Fax:503-494-4982
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD
Practice Address - Street 2:MAIL CODE L340
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3011
Practice Address - Country:US
Practice Address - Phone:503-494-4511
Practice Address - Fax:503-494-4982
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2014-01-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORMD292232085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology