Casey Omori
Physician Assistant in Beaverton, OR. Individual provider (NPI-1).
NPI number1336762467
StatusActive
Last updated in NPPESMar 24, 2023
Details
- NPI
- 1336762467
- Entity type
- Individual (NPI-1)
- Name
- Casey Omori
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 22, 2020
- Certification date
- Mar 24, 2023
- Last updated
- Mar 24, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 214457 | OR | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
14278 Sw Allen BlvdBeaverton, OR 97005-4405
Phone 503-305-6262
Mailing address
14278 Sw Allen BlvdBeaverton, OR 97005-4405
Other practice locations
222 Se 8th Ave Ste 536
Hillsboro, OR 97123-4218
Hillsboro, OR 97123-4218
Phone 503-352-7272
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All 45 Physician Assistant providers in Beaverton · All 4,562 providers in Beaverton
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