Individual
ILEANA MARIA ESQUIVEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, L353, PORTLAND, OR 97239-3011
(503) 494-7820
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8607
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA00932
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1034980
—
WA
05
—
500604923
—
OR
Enumeration date
07/31/2006
Last updated
10/06/2020
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