Most Relevant Information
Provider Data
| NPI Number: | 1003388851 |
| Provider Name: | MOLLY ANDERSON PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363AM0700X |
| Specialty: | Physician Assistant |
| License Number: | PA194571 |
Most Important Dates
| Enumeration Date: | 12/18/2018 |
| Last Updated: | 01/15/2021 |
Provider Practice Location
3181 SW SAM JACKSON PARK RD
PORTLAND
OR
97239
Practice Location Phone/Fax
| Phone: | 5034944910 |
| Fax: |
Provider Mailing Location
3181 SW SAM JACKSON PARK RD
MAIL CODE SJH-2
PORTLAND
OR
972393011
Provider Mailing Phone/Fax
| Phone: | 5034944910 |
| Fax: | 5034948368 |