Individual
MRS. PAULA DEANNE DIETSCH KUIPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
501 N GRAHAM ST, SUITE 220, PORTLAND, OR 97227-1654
(503) 413-6200
(503) 413-6422
Mailing address
501 N GRAHAM ST, SUITE 220, PORTLAND, OR 97227-1654
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA10003216
WA
363AS0400X
Surgical Physician Assistant
Primary
PA000475
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8420085
—
WA
Enumeration date
05/27/2005
Last updated
03/21/2024
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