Individual
AUDREY RAYNE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12345 SW HORIZON BLVD STE 57, BEAVERTON, OR 97007-9475
(503) 216-8820
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA213477
OR
363AM0700X
Medical Physician Assistant
PA213477
OR
Other
Enumeration date
05/24/2020
Last updated
02/24/2025
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