Provider Demographics
NPI:1588841522
Name:PERKINS, ROSINA SERENE (MD)
Entity Type:Individual
Prefix:
First Name:ROSINA
Middle Name:SERENE
Last Name:PERKINS
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 1:3186 SW SAM JACKSON PARK ROAD
Mailing Address - Street 2:L-223A
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3098
Mailing Address - Country:US
Mailing Address - Phone:503-494-8372
Mailing Address - Fax:
Practice Address - Street 1:3760 PIPER ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4683
Practice Address - Country:US
Practice Address - Phone:907-330-9909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-22
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD26919208600000X
AK199311208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery