Individual
MICHAEL PATRIC CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9250 SW HALL BLVD, TIGARD, OR 97223-6721
(503) 293-0161
Mailing address
800 SW 13TH AVE, PORTLAND, OR 97205-1902
(503) 221-0161
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01309
OR
Other
Enumeration date
09/24/2007
Last updated
11/06/2020
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