Individual
KATY KWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8645 SE SUNNYBROOK BLVD STE 200, CLACKAMAS, OR 97015-6841
(503) 659-1694
(503) 659-8984
Mailing address
8645 SE SUNNYBROOK BLVD STE 200, CLACKAMAS, OR 97015-6841
(503) 659-1694
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA150450
OR
Other
Enumeration date
12/24/2009
Last updated
04/16/2020
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