Provider Demographics
NPI:1831207372
Name:AVERY, ANNE KATHARINE (MD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:KATHARINE
Last Name:AVERY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13705 NE AIRPORT WAY STE C
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-1048
Mailing Address - Country:US
Mailing Address - Phone:503-258-6800
Mailing Address - Fax:503-258-6864
Practice Address - Street 1:13705 NE AIRPORT WAY STE C
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-1048
Practice Address - Country:US
Practice Address - Phone:503-258-6800
Practice Address - Fax:503-258-6864
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OROR MD25120207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology