Individual
BRANDY SHAY PESTKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5555 N CHANNEL AVE, BLD. 72, PORTLAND, OR 97217-7655
(503) 228-0295
Mailing address
5555 N CHANNEL AVE, BLD. 72, PORTLAND, OR 97217-7655
(503) 228-0295
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/23/2012
Last updated
01/21/2015
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