Dougherty, Laura Desiree
Dougherty, Laura Desiree is an individual health care provider with primary practice located at 9775 Se Sunnyside Rd Ste 500 , Clackamas OR 97015-5724. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Dougherty, Laura Desiree can be contacted via phone (503) 654-7546.Contact Information
Primary practice address
9775 Se Sunnyside Rd Ste 500
Clackamas OR 97015-5724
Phone: (503) 654-7546
Fax: (503) 786-3542
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA19988 | California |
Profile Details
| NPI number | 1316913387 |
|---|---|
| LBN Legal business name | Dougherty, Laura Desiree |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 28th, 2006 |
| Last updated | Nov 17th, 2022 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316913387 | NPPES |
| California | Other | PA19988 | CALIFORNIA LICENSE |
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