Individual
ERICA T BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
501 N GRAHAM ST, STE 200, PORTLAND, OR 97227-1654
(503) 413-4710
(503) 413-4711
Mailing address
PO BOX 3777, PORTLAND, OR 97208-3777
(503) 413-4710
(503) 413-4711
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA169996
OR
Other
Enumeration date
04/12/2013
Last updated
11/29/2016
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