Provider Demographics
NPI:1710392170
Name:BISO, SYLVIA MARIE RABE (MD)
Entity Type:Individual
Prefix:MS
First Name:SYLVIA MARIE
Middle Name:RABE
Last Name:BISO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SYLVIA MARIE
Other - Middle Name:R
Other - Last Name:BISO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3181 SW SAM JACKSON PARK RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3098
Mailing Address - Country:US
Mailing Address - Phone:503-494-5682
Mailing Address - Fax:
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3011
Practice Address - Country:US
Practice Address - Phone:503-494-5682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD461483207R00000X
ORMD203925207R00000X, 207RC0000X, 207UN0901X
VA0101278853207RC0000X
PAMT206835390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology