Individual
MISS MOLLY CHRISTINE MCCLUSKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
16083 SW UPPER BOONES FERRY RD, 130, TIGARD, OR 97224
(503) 603-9087
(503) 603-9122
Mailing address
16083 SW UPPER BOONES FERRY RD, 130, TIGARD, OR 97224
(503) 603-9087
(503) 603-9122
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA207464
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/02/2020
Last updated
09/13/2022
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