Most Relevant Information
Provider Data
| NPI Number: | 1003494659 |
| Provider Name: | WINNIE GAYALWA SHIVEGA MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/01/2021 |
| Last Updated: | 04/01/2021 |
Provider Practice Location
3181 SW SAM JACKSON PARK RD
PORTLAND
OR
972393098
Practice Location Phone/Fax
| Phone: | 5034948211 |
| Fax: |
Provider Mailing Location
3181 SW SAM JACKSON PARK RD
PORTLAND
OR
972393098
Provider Mailing Phone/Fax
| Phone: | 5034948211 |
| Fax: |