Individual
KAREN L KOSTENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1350 NE 122ND AVE STE 200, PORTLAND, OR 97230-2011
(503) 408-7008
(503) 666-6745
Mailing address
1350 NE 122ND AVE STE 200, PORTLAND, OR 97230-2011
(503) 408-7008
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA187236
OR
363AM0700X
Medical Physician Assistant
53029
CA
Other
Enumeration date
06/26/2015
Last updated
01/15/2020
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