Individual
KATHRYN PEAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2275 W BURNSIDE ST STE B, PORTLAND, OR 97210-3541
(503) 575-7112
Mailing address
2275 W BURNSIDE ST STE B, PORTLAND, OR 97210-3541
(503) 575-7112
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA194744
OR
Other
Enumeration date
01/30/2012
Last updated
10/11/2023
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