Individual
MACI PFAFFENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2850 SE POWELL VALLEY RD, GRESHAM, OR 97080
(503) 666-5050
(503) 666-1162
Mailing address
PO BOX 3777, PORTLAND, OR 97208-3777
(503) 413-3900
(503) 413-3710
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA180305
OR
363AM0700X
Medical Physician Assistant
Primary
PA180305
OR
Other
Enumeration date
07/19/2016
Last updated
08/15/2018
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