Provider Demographics
NPI:1538295795
Name:SIEGAL, FRANCINE MARTHA (MD)
Entity Type:Individual
Prefix:
First Name:FRANCINE
Middle Name:MARTHA
Last Name:SIEGAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 NW 11TH AVE
Mailing Address - Street 2:APT. # PH-1
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-2776
Mailing Address - Country:US
Mailing Address - Phone:503-221-1046
Mailing Address - Fax:503-227-0183
Practice Address - Street 1:2455 NW MARSHALL ST
Practice Address - Street 2:SUITE # 3
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-2949
Practice Address - Country:US
Practice Address - Phone:503-221-1046
Practice Address - Fax:503-227-0183
Is Sole Proprietor?:No
Enumeration Date:2007-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD091392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORC93774Medicare UPIN