Individual
TERRY PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSFA
Contact information
Practice address
9205 SW BARNES RD, PORTLAND, OR 97225-6603
(503) 216-2151
Mailing address
PO BOX 25687, PORTLAND, OR 97298-0687
(503) 680-3063
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
159811
OR
Other
Enumeration date
07/27/2015
Last updated
07/27/2015
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