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Individual

MICHAEL PTAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
10690 NE CORNELL RD STE 220, HILLSBORO, OR 97124-9224
(503) 848-5861
Mailing address
6420 SW MACADAM AVE STE 300, PORTLAND, OR 97239-3519
(503) 941-3077

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201900293RN
OR

Other

Enumeration date
04/08/2019
Last updated
04/08/2019
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