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DAVID NATHANIEL COUNTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
16770 SW EDY RD, SUITE 102, SHERWOOD, OR 97140-9678
(503) 216-9600
(503) 216-9650
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA155942
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500644216
OR
01
P01238428
RR MEDICARE (PH&S)
OR
Enumeration date
10/10/2011
Last updated
02/19/2021
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