Individual provider · Type 1 NPI

Carol Lynne Sticker, PA-C

Medical Physician Assistant · Portland, OR

NPI number 1639375405 Active

Practice location

4805 NE Glisan St Ste 6N60
Portland, OR 97213-2933

Call (503) 215-5526 Map

Fax (503) 416-7377

Mailing address

847 NE 19th Ave Ste 300
Portland, OR 97232-2686

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA194156 (OR)
Physician Assistant 363A00000XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1639375405

Carol Lynne Sticker, PA-C's National Provider Identifier is 1639375405, issued on Jun 26, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Portland, OR. The record was last updated on Mar 22, 2021.