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Individual

AMY L CELICHOWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
10330 SE 32ND AVE, SUITE 205, MILWAUKIE, OR 97222-6594
(503) 513-8950
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA150706
OR
363AM0700X
Medical Physician Assistant
1634
TN
363AM0700X
Medical Physician Assistant
PA150706
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500656757
OR
Enumeration date
10/31/2008
Last updated
02/18/2021
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