Provider Demographics
NPI:1750370680
Name:VINOCUR, MARCELA J (MD)
Entity type:Individual
Prefix:DR
First Name:MARCELA
Middle Name:J
Last Name:VINOCUR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1776 SW MADISON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-1715
Mailing Address - Country:US
Mailing Address - Phone:503-224-1044
Mailing Address - Fax:503-621-2235
Practice Address - Street 1:1438 SE DIVISION ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-1140
Practice Address - Country:US
Practice Address - Phone:503-548-0346
Practice Address - Fax:503-232-5959
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2024-02-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORMD167222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2076176Medicaid
OR500700499Medicaid