Individual
MR. PETER BOWEN HJORTH III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, MPH
Contact information
Practice address
200 NE MOTHER JOSEPH PL STE 320, VANCOUVER, WA 98664-3205
(360) 514-6300
(360) 514-6301
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7820
(503) 494-7829
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61049844
WA
363AS0400X
Surgical Physician Assistant
PA197800
OR
Other
Enumeration date
03/18/2020
Last updated
06/01/2020
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