Individual
KARI ANN SIVERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8372
Mailing address
19361 TUALAMERE AVE, LAKE OSWEGO, OR 97035-8021
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01107
OR
Other
Enumeration date
07/18/2006
Last updated
07/08/2007
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