Individual
MICHELLE ANNE RADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3377 RIVERBEND DR, SPRINGFIELD, OR 97477-8803
(541) 222-6200
(541) 222-6182
Mailing address
PO BOX 24410, EUGENE, OR 97402-0451
(541) 984-4301
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01411
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164676441
—
OR
Enumeration date
11/12/2008
Last updated
11/23/2011
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