Individual
MICHELLE M EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1108 JUNE ST, HOOD RIVER, OR 97031-1513
(541) 387-6125
(541) 387-6321
Mailing address
PO BOX 3390, PORTLAND, OR 97208-3390
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01298
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2718104
—
OR
05
—
500608081
—
OR
Enumeration date
12/21/2007
Last updated
03/09/2021
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