Individual
ANDREA SUSAN HERZKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-6400
Mailing address
160 SW PARKSIDE LN, PORTLAND, OR 97205-5852
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
MD25988
OR
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
MD25988
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270027
—
OR
Enumeration date
07/31/2006
Last updated
08/27/2024
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