Provider Demographics
NPI:1982742110
Name:FRANZINI, DAISY A (MD)
Entity Type:Individual
Prefix:
First Name:DAISY
Middle Name:A
Last Name:FRANZINI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5919 SW 52ND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97221-1722
Mailing Address - Country:US
Mailing Address - Phone:503-268-4802
Mailing Address - Fax:503-268-4801
Practice Address - Street 1:1015 NW 22ND AVE
Practice Address - Street 2:LEGACY GOOD SAMARITAN HOSP. PATHOLOGY DEPT T-100
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-3025
Practice Address - Country:US
Practice Address - Phone:503-413-7319
Practice Address - Fax:503-413-6411
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD17086207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8345548Medicaid
OR050299Medicaid
OR931071318OtherTAX ID
OR931071318OtherTAX ID
WAG8879633Medicare PIN
ORR00WCMBLFMedicare PIN
OR050299Medicaid