NPI 1003674714

Laurel Long, PAC

Practitioner Physician Assistant Beaverton, OR

Practice location

Address: 14278 SW Allen Blvd, Beaverton, OR 97005-4405
Phone: (503) 305-6262
Mailing address: 8060 SW Pfaffle St STE 106, Tigard, OR 97223-8489

Registered specialties (2)

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence PA22399 (OR)

Other Physician Assistant providers in Oregon →

Behavior Technician

Behavioral Health & Social Service Providers Taxonomy 106S00000X Licence ABA-IN-10241615 (OR)

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Registry record

NPI: 1003674714
Entity type: Individual
Sex (as registered): Female
NPI issued: 7 Mar 2024
Record last updated: 18 Feb 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.