Individual
KATIE LYNN MENCOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, MSPAS
Contact information
Practice address
5050 NE HOYT ST STE 240, PORTLAND, OR 97213-2981
(503) 215-6480
(503) 215-6469
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA196074
OR
Other
Enumeration date
01/13/2020
Last updated
06/09/2023
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