Individual
MICHAEL JOHN PADRTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12512 SE STARK ST, PORTLAND, OR 97233-1070
(503) 906-9995
Mailing address
12540 SW MAIN ST, TIGARD, OR 97223-6198
(503) 906-9995
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/07/2023
Last updated
11/07/2023
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