Individual
ASA MARIE ATWATER DI CARLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
448 N WERTH BLVD, NEWBERG, OR 97132-7500
(503) 554-2516
Mailing address
2604 SE 15TH AVE, PORTLAND, OR 97202-1110
(503) 367-6833
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61525974
WA
363A00000X
Physician Assistant
—
—
Other
Enumeration date
05/26/2023
Last updated
03/25/2024
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