Individual
MR. JOSHIN ADRALD LUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8562
(503) 494-6324
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8562
(503) 494-6324
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA167747
OR
363AM0700X
Medical Physician Assistant
Primary
PA167747
OR
Other
Enumeration date
07/22/2013
Last updated
12/18/2020
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