Individual
MS. COLLEEN D PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12400 NW CORNELL RD STE 200, PORTLAND, OR 97229-5689
(503) 646-0101
(503) 350-1420
Mailing address
9850 NW JUSTUS LN, PORTLAND, OR 97229-8551
(503) 297-5155
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA00406
OR
Other
Enumeration date
12/01/2006
Last updated
07/08/2007
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