CODY LEE BALLARD

PORTLAND, OR
NPI1710258066
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: OR  PA164961)
Enumeration Date2012-01-18
Last Update Date2020-12-17
Business Address
Mr. CODY LEE BALLARD PA-C
3181 SW SAM JACKSON PARK RD GH219
PORTLAND, OR 97239-3011
Phone number: 503-438-8822
Mailing Address
Mr. CODY LEE BALLARD PA-C
3181 SW SAM JACKSON PARK RD # UHN-62
PORTLAND, OR 97239-3011
Phone number: 503-494-1775
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