Provider Demographics
NPI:1265239578
Name:TODD, DIANA JANINE
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:JANINE
Last Name:TODD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:ELLIOT
Other - Middle Name:
Other - Last Name:TODD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:18000 SW JAY ST
Mailing Address - Street 2:
Mailing Address - City:ALOHA
Mailing Address - State:OR
Mailing Address - Zip Code:97003-3738
Mailing Address - Country:US
Mailing Address - Phone:503-686-1337
Mailing Address - Fax:
Practice Address - Street 1:10123 SE MARKET ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-2532
Practice Address - Country:US
Practice Address - Phone:503-257-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula