Individual provider · Type 1 NPI

Ian Richard Penner, PA-C

Medical Physician Assistant · Scappoose, OR

NPI number 1457680613 Active

Practice location

51377 SW Old Portland Rd
Scappoose, OR 97056-4018

Call (503) 543-3181 Map

Mailing address

2717 NE 10th Ave
Portland, OR 97212-3209

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XNone listed
Physician Assistant 363A00000XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1457680613

Ian Richard Penner, PA-C's National Provider Identifier is 1457680613, issued on Dec 17, 2009. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Scappoose, OR. The record was last updated on Dec 29, 2020.