Individual provider · Type 1 NPI

Roberta Nadine Vandentop, PHYSICIAN ASSISTANT

Medical Physician Assistant · Portland, OR

NPI number 1124109889 Active

Practice location

1815 SW Marlow Ave, Ste 110
Portland, OR 97225-5185

Call (503) 296-0918 Map

Fax (503) 296-6158

Mailing address

14807 NW Applegate Ln
Portland, OR 97229-1899

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1124109889

Roberta Nadine Vandentop, PHYSICIAN ASSISTANT's National Provider Identifier is 1124109889, issued on Oct 18, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Portland, OR. The record was last updated on Jul 8, 2007.