Individual provider · Type 1 NPI

Robert Dylan Mangrum, PA-C

Surgical Physician Assistant · Portland, OR

NPI number 1871546838 Active

Practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Call (503) 494-8311 Map

Other practice locations

  • 3303 S Bond Ave, Portland, OR 97239-4501 · (503) 494-6400
  • 15700 SW Greystone Ct, Beaverton, OR 97006-6011 · (503) 494-6400

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XPA9101478 (FL)
Surgical Physician Assistant Primary 363AS0400XPA172009 (OR)

Surgical Physician Assistant: Definition to come...

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About NPI 1871546838

Robert Dylan Mangrum, PA-C's National Provider Identifier is 1871546838, issued on May 18, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Portland, OR. The record was last updated on Nov 16, 2023.