Individual
MRS. KRISTIANNA E DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2265 EXCHANGE ST, ASTORIA, OR 97103-3331
(503) 338-4075
(503) 338-4076
Mailing address
2111 EXCHANGE ST, ASTORIA, OR 97103-3329
(503) 325-4321
(503) 338-4076
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA19912
CA
363AS0400X
Surgical Physician Assistant
PA155818
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/07/2007
Last updated
01/09/2019
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