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Individual

DAVID M COLLINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
450 TATONE STREET, BOARDMAN, OR 97818
(541) 481-7212
(541) 481-2020
Mailing address
PO BOX 397, BOARDMAN, OR 97818
(541) 481-7212
(541) 481-2020

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA01149
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
227616
OR
Enumeration date
12/11/2006
Last updated
05/04/2012
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