Individual
AMANDA KAY MATZKE VANSANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD # L113, PORTLAND, OR 97239-3011
(503) 494-8276
Mailing address
3181 SW SAM JACKSON PARK RD # L113, PORTLAND, OR 97239-3011
(503) 494-8276
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
DO156796
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/21/2008
Last updated
05/29/2013
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