Individual
MICHAEL EDWARD PURVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
9155 SW BARNES RD STE 440, PORTLAND, OR 97225-6631
(503) 935-8500
(503) 935-8505
Mailing address
541 NE 20TH AVE STE 225, PORTLAND, OR 97232-2895
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA202232
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500787174
—
OR
Enumeration date
05/01/2019
Last updated
11/22/2023
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