Individual
JILL J STOREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2730 SW MOODY AVE, MAIL CODE: CL5PA, PORTLAND, OR 97201
(503) 494-3633
Mailing address
1226 SE PINE ST, PORTLAND, OR 97214-1432
(559) 960-1016
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA201658
OR
Other
Enumeration date
05/01/2019
Last updated
01/15/2021
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