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1710063110
ANGELA MARIE BLACK
TIGARD, OR
NPI
1710063110
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: OR PA00941)
Enumeration Date
2006-10-27
Last Update Date
2023-03-07
Business Address
ANGELA MARIE BLACK PA
11900 SW GREENBURG RD
TIGARD, OR 97223-6453
Phone number: 503-620-5556
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Mailing Address
ANGELA MARIE BLACK PA
11900 SW GREENBURG RD
TIGARD, OR 97223-6453
Phone number: 503-620-5556
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