Black, Angela Marie

Black, Angela Marie is an individual health care provider with primary practice located at 11900 Sw Greenburg Rd , Tigard OR 97223-6453. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Black, Angela Marie can be contacted via phone (503) 620-5556.

Contact Information

Primary practice address
11900 Sw Greenburg Rd Tigard OR 97223-6453
Phone: (503) 620-5556
Fax: (503) 624-0118
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA00941 Oregon

Profile Details

NPI number 1710063110
LBN Legal business name Black, Angela Marie
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2006
Last updated Mar 7th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710063110 NPPES
Oregon Other PA00941 STATE LICENSE

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