Individual
MS. NINA O'MAILIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
21900 WILLAMETTE DR STE 209, WEST LINN, OR 97068-3284
(971) 274-0038
(971) 202-2099
Mailing address
11507 SE FLAVEL ST, PORTLAND, OR 97266-5985
(503) 915-2090
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA152466
OR
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500604590
—
OR
05
—
8508384
—
WA
Enumeration date
02/21/2008
Last updated
04/25/2023
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