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Individual

MRS. AMANDA LYNN DICK PEDOTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2850 SE POWELL VALLEY RD STE 100, GRESHAM, OR 97080-1495
(503) 666-5050
Mailing address
14605 NE BROADWAY, PORTLAND, OR 97230-4130
(510) 910-4924

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA183299
OR
363A00000X
Physician Assistant
PA21501
CA

Other

Enumeration date
03/10/2011
Last updated
07/21/2022
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