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Individual

LARA ANNA CLAYTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
3303 SW BOND AVE, CH16D, PORTLAND, OR 97239-4501
(503) 418-3376
(503) 494-6968
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 418-3376
(503) 494-6968

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA164160
OR
363A00000X
Physician Assistant
363AM0700X
Medical Physician Assistant
Primary
PA164160
OR

Other

Enumeration date
08/06/2007
Last updated
01/13/2021
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