Individual
JUSTINE RICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2415 N ORANGE AVE STE 601, ORLANDO, FL 32804-5558
(407) 303-2070
(407) 303-2071
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-3442
(503) 494-5330
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA187080
OR
363A00000X
Physician Assistant
Primary
PA9117109
FL
363AM0700X
Medical Physician Assistant
PA187080
OR
Other
Enumeration date
02/13/2018
Last updated
02/07/2025
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