Individual
JOY CHIYO DAWN GEPHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
1825 MAPLE ST, FOREST GROVE, OR 97116-1939
(503) 357-2136
(503) 359-5479
Mailing address
1825 MAPLE ST, FOREST GROVE, OR 97116-1939
(503) 357-2136
(503) 359-5479
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01234
OR
Other
Enumeration date
05/29/2007
Last updated
09/14/2010
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