Provider Demographics
NPI:1740441351
Name:MCGEORGE, MARLA JO (DVM)
Entity type:Individual
Prefix:DR
First Name:MARLA
Middle Name:JO
Last Name:MCGEORGE
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4407 SW CORBETT AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-4268
Mailing Address - Country:US
Mailing Address - Phone:503-892-6452
Mailing Address - Fax:
Practice Address - Street 1:4407 SW CORBETT AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-4268
Practice Address - Country:US
Practice Address - Phone:503-892-6452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4304174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian