Individual
SAMANTHA R TRAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9427 SW BARNES RD STE 593, PORTLAND, OR 97225-6640
(503) 216-8670
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA222607
OR
Other
Enumeration date
08/30/2024
Last updated
02/27/2025
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