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MORIO C MCWILLIAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
4805 NE GLISAN ST, SUITE 6N50, PORTLAND, OR 97213-2933
(503) 215-2300
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2706
WI
363A00000X
Physician Assistant
Primary
PA158499
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500648656
OR
Enumeration date
01/21/2011
Last updated
10/15/2012
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