Individual
MS. MARY C REGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
51377 SW OLD PORTLAND RD, SCAPPOOSE, OR 97056-4023
(503) 418-4222
(503) 418-4223
Mailing address
51377 SW OLD PORTLAND RD, SCAPPOOSE, OR 97056-4023
(503) 418-4222
(503) 418-4223
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
APA14888
CA
363A00000X
Physician Assistant
PA196072
OR
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
09/20/2005
Last updated
12/29/2020
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