Dwyhalo, Kristina Marie
Dwyhalo, Kristina Marie is an individual health care provider with primary practice located at 9900 Se Sunnyside Rd , Clackamas OR 97015-9777. 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. Dwyhalo, Kristina Marie can be contacted via phone (503) 571-4222.Contact Information
Primary practice address
9900 Se Sunnyside Rd
Clackamas OR 97015-9777
Phone: (503) 571-4222
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA170407 | Oregon |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA60514736 | Washington |
Profile Details
| NPI number | 1346676186 |
|---|---|
| LBN Legal business name | Dwyhalo, Kristina Marie |
| Credentials | MSPA |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 25th, 2013 |
| Last updated | Jan 16th, 2015 - about 10 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 | 1346676186 | NPPES |
| Arizona | MEDICAID | 857733 |
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