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1013441997
THERESA M RARDIN
GRESHAM, OR
NPI
1013441997
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: OR PA182032)
Enumeration Date
2017-04-17
Last Update Date
2017-04-17
Business Address
-- THERESA M RARDIN PA
24900 SE STARK ST STE 208
GRESHAM, OR 97030-3382
Phone number: 503-666-8149
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Mailing Address
-- THERESA M RARDIN PA
4432 NE CESAR E CHAVEZ BLVD
PORTLAND, OR 97211-8232
Phone number: 503-867-0019
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