Individual
ELIZABETH PETRUSKA KNAPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PA-C
Contact information
Practice address
3303 SW BOND AVE, MAIL CODE: CHH5E, PORTLAND, OR 97239-4501
(503) 494-5421
Mailing address
3303 SW BOND AVE, MAIL CODE: CHH5E, PORTLAND, OR 97239-4501
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
157071
OR
Other
Enumeration date
07/08/2010
Last updated
06/05/2012
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