Individual
MICHAEL ANTHONY ST AMAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
301 NE KNOTT ST, PORTLAND, OR 97212-3014
(503) 253-3910
(503) 253-4297
Mailing address
301 NE KNOTT ST, PORTLAND, OR 97212-3014
(503) 253-3910
(503) 253-4297
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
363AS0400X
Surgical Physician Assistant
Primary
PA213270
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2222166
—
WA
05
—
500811653
—
OR
Enumeration date
05/17/2018
Last updated
11/12/2025
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