Individual
MADELENE PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5308 N LOMBARD ST, PORTLAND, OR 97203-4218
(888) 227-5155
(971) 282-0085
Mailing address
PO BOX 2908, PORTLAND, OR 97208-2908
(425) 207-5155
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA223183
OR
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/09/2023
Last updated
12/11/2024
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