Individual
BREEANA K ROCHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
19260 SW 65TH AVE STE 435, TUALATIN, OR 97062
(503) 692-2032
Mailing address
1498 SE TECH CENTER PL STE 240, VANCOUVER, WA 98683-5508
(360) 597-1309
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
153001
OR
Other
Enumeration date
09/07/2008
Last updated
11/26/2018
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