Individual
JOAN RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
14601 SE DIVISION ST, PORTLAND, OR 97236-2333
(888) 875-7820
Mailing address
14601 SE DIVISION ST, PORTLAND, OR 97236-2333
(888) 875-7820
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA213508
OR
Other
Enumeration date
02/21/2021
Last updated
01/04/2023
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