Individual
MS. MADELYN DAN DO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9155 SW BARNES RD STE 238, PORTLAND, OR 97225-6629
(503) 216-6407
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA162008
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285942078
—
WA
05
—
500656356
—
OR
Enumeration date
09/15/2010
Last updated
04/21/2023
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