Individual
MARC KRISTOPHER OBANDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2850 SE POWELL VALLEY RD, GRESHAM, OR 97080-1494
(503) 666-5050
Mailing address
PO BOX 3777, PORTLAND, OR 97208-3777
(503) 413-3900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA209437
OR
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA209437
MEDICAL LICENSE
OR
Enumeration date
08/31/2015
Last updated
02/02/2024
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