Individual
CELESTE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9900 SE SUNNYSIDE RD, KAISER PERMANENTE SUNNYBROOK MEDICAL OFFICE, CLACKAMAS, OR 97015-9777
(503) 813-4756
(877) 821-5101
Mailing address
9900 SE SUNNYSIDE RD, KAISER PERMANENTE SUNNYBROOK MEDICAL OFFICE, CLACKAMAS, OR 97015-9777
(877) 821-5101
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 180390
OR
363A00000X
Physician Assistant
PA 60705018
WA
Other
Enumeration date
12/28/2015
Last updated
12/01/2016
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