Individual
CATHLEEN L HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7820
Mailing address
1400 SW 5TH AVE STE 500, PORTLAND, OR 97201-5537
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA17443
CA
363AS0400X
Surgical Physician Assistant
Primary
PA01239
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00PA174430
—
CA
Enumeration date
03/23/2006
Last updated
07/15/2025
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