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Individual

MRS. SAMANTHA MARIE RAPHAEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3181 SW SAM JACKSON PARK RD, OP31, PORTLAND, OR 97239-3011
(503) 494-6400
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-6400

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA150291
OR
363AS0400X
Surgical Physician Assistant
Primary
PA150291
OR

Other

Enumeration date
10/01/2009
Last updated
05/22/2024
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