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Individual

IRINA KILYUSHIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
19500 SE STARK ST, PORTLAND, OR 97233-5757
(800) 813-2000
Mailing address
3448 SE 164TH AVE, PORTLAND, OR 97236-1876

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA216202
OR

Other

Enumeration date
06/01/2023
Last updated
06/28/2023
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