Individual
KRISTIN KATHLEEN MAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
19250 SW 65TH AVE, SUITE 235, TUALATIN, OR 97062-7452
(503) 692-4820
(503) 612-0793
Mailing address
847 NE 19TH AVE, SUITE 300, PORTLAND, OR 97232-2684
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
011967
NY
363AS0400X
Surgical Physician Assistant
Primary
PA150681
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500602008
—
OR
Enumeration date
10/11/2007
Last updated
08/15/2016
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