Provider Demographics
NPI:1578629507
Name:FLORES, MARCELLA MADELEINE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCELLA
Middle Name:MADELEINE
Last Name:FLORES
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 1:3948 SW SCHOLLS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97221-1269
Mailing Address - Country:US
Mailing Address - Phone:503-292-9298
Mailing Address - Fax:
Practice Address - Street 1:17175 SW TUALATIN VALLEY HWY
Practice Address - Street 2:
Practice Address - City:ALOHA
Practice Address - State:OR
Practice Address - Zip Code:97006-4584
Practice Address - Country:US
Practice Address - Phone:503-681-4223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10073207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine