Individual
MS. DORI M MACDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
19185 SW 90TH AVE, TUALATIN, OR 97062-7558
(503) 885-7300
Mailing address
19185 SW 90TH AVE, TUALATIN, OR 97062-7558
(503) 885-7300
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA00313
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA00313
OREGON BOARD LICENSE
OR
Enumeration date
01/03/2007
Last updated
07/11/2007
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