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Individual

LAARNIE DANTE CHACO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT

Contact information

Practice address
689 NW BURNSIDE RD, GRESHAM, OR 97030-3739
(503) 382-8100
(503) 382-8120
Mailing address
PO BOX 3777, PORTLAND, OR 97208-3777
(503) 413-3900
(503) 413-3710

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA176646
OR
363A00000X
Physician Assistant
PA21444
CA

Other

Enumeration date
03/01/2011
Last updated
09/29/2021
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