Most Relevant Information
Provider Data
| NPI Number: | 1003696162 |
| Provider Name: | MARIA SHEDA DIKEMAN |
| Entity Type: | Individual |
| Taxonomy Code: | 376G00000X |
| Specialty: | Nursing Home Administrator |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/04/2023 |
| Last Updated: | 10/04/2023 |
Provider Practice Location
4620 SW 202ND AVE
BEAVERTON
OR
970782250
Practice Location Phone/Fax
| Phone: | 5037402212 |
| Fax: |
Provider Mailing Location
4620 SW 202ND AVE
BEAVERTON
OR
970782250
Provider Mailing Phone/Fax
| Phone: | 5037402212 |
| Fax: |