Individual
PETER P MUSACCHIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
9800 SE SUNNYSIDE ROAD, CLACKAMAS, OR 97015-9750
(503) 653-6440
Mailing address
9800 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-9750
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA00641
OR
363AS0400X
Surgical Physician Assistant
PA10004785
WA
Other
Enumeration date
10/02/2006
Last updated
07/10/2007
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