Provider Demographics
NPI:1629014303
Name:SIMS, SILVIA DAINA (MD)
Entity Type:Individual
Prefix:
First Name:SILVIA
Middle Name:DAINA
Last Name:SIMS
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 1:9290 SE SUNNYBROOK BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-6899
Mailing Address - Country:US
Mailing Address - Phone:503-659-1694
Mailing Address - Fax:503-659-8984
Practice Address - Street 1:9290 SE SUNNYBROOK BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-6899
Practice Address - Country:US
Practice Address - Phone:503-659-1694
Practice Address - Fax:503-659-8984
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN40950208000000X
ORMD163549208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500664187Medicaid