Individual
JAMIE MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2875 NE STUCKI AVE, HILLSBORO, OR 97124
(971) 413-8027
Mailing address
6854 NE WILLOWGROVE ST, HILLSBORO, OR 97124-8098
(720) 323-9194
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
150728
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730391665
—
OR
Enumeration date
05/04/2007
Last updated
07/09/2018
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