Individual
MISS AMANDA VANSANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
702 SUNSET DR, ONTARIO, OR 97914
(541) 889-9167
(541) 889-7873
Mailing address
702 SUNSET DR, ONTARIO, OR 97914-3121
(541) 889-9167
(541) 889-7873
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA1233
ID
363A00000X
Physician Assistant
Primary
PA160191
OR
Other
Enumeration date
12/17/2012
Last updated
03/21/2019
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