Individual
LAURA BEHRENDS POGGIALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
16180 SE SUNNYSIDE RD, STE 102, HAPPY VALLEY, OR 97015-6301
(503) 582-4900
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA170977
OR
363A00000X
Physician Assistant
PA60188653
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500682750
—
OR
01
—
P01522452
RR MEDICARE (PH&S)
OR
Enumeration date
10/05/2010
Last updated
06/21/2021
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