Individual
MR. SEAN ROBERT CUSHING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
10123 SE MARKET ST, PORTLAND, OR 97216-2532
(503) 251-6168
Mailing address
5806 NE 23RD AVE, PORTLAND, OR 97211-2710
(971) 235-5913
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA 153108
OR
363AM0700X
Medical Physician Assistant
PA 19589
CA
Other
Enumeration date
06/02/2008
Last updated
12/12/2016
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