Individual
MS. TERESSA ELIZABETH HAEFELE RAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9155 SW BARNES RD STE 440, PORTLAND, OR 97225
(503) 935-8500
(503) 935-8505
Mailing address
847 NE 19TH AVE STE 300, PORTLAND, OR 97232-2686
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA168447
OR
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
03/20/2013
Last updated
12/29/2020
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