Individual provider · Type 1 NPI

Michael Hollenback, P.A.-C.

Surgical Physician Assistant · Clackamas, OR

NPI number 1003923293 Active

Practice location

9800 SE Sunnyside Rd
Clackamas, OR 97015-9750

Call (503) 653-6440 Map

Mailing address

11603 SE Flavel St
Portland, OR 97266-5980

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XPA00498 (OR)
Surgical Physician Assistant 363AS0400XPA10003619 (WA)

Surgical Physician Assistant: Definition to come...

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About NPI 1003923293

Michael Hollenback, P.A.-C.'s National Provider Identifier is 1003923293, issued on Aug 24, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Clackamas, OR. The record was last updated on Jul 8, 2007.