Individual
DANIEL SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1003 PROVIDENCE DR, SUITE 210, NEWBERG, OR 97132-7523
(503) 537-5900
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA165115
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/19/2012
Last updated
06/25/2021
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