Individual
AMANDA CATHERINE TEP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
9205 SW BARNES RD STE MT2800, PORTLAND, OR 97225-6603
(503) 216-2621
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
PG210936
OR
Other
Enumeration date
04/08/2020
Last updated
07/18/2022
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