Individual
LIBERTY ROBINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9800 SE SUNNYSIDE RD, CLACKAMAS, OR 97015
(503) 813-2000
Mailing address
9800 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-9301
(503) 813-2000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA60699924
WA
363AM0700X
Medical Physician Assistant
Primary
PA00989
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA00989
LICENSE
OR
Enumeration date
05/22/2007
Last updated
03/07/2023
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