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Individual

ANNA LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
24076 SE STARK ST, SUITE 230, GRESHAM, OR 97030-3373
(503) 488-2600
(503) 465-5468
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
363A00000X
Physician Assistant
Primary
PA179891
OR
363AS0400X
Surgical Physician Assistant
PA179891
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2069949
WA
05
500718081
OR
Enumeration date
11/03/2016
Last updated
06/20/2025
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