NPI 1154082022

Katherine Vestakis

Practitioner Physician Assistant Gresham, OR

Practice location

Address: 24988 SE Stark St STE 220, Gresham, OR 97030-8324
Phone: (503) 674-1580
Mailing address: PO Box 4365, Portland, OR 97208-4365

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence PA217362 (OR)

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Registry record

NPI: 1154082022
Entity type: Individual
Sex (as registered): Female
NPI issued: 4 Jan 2022
Record last updated: 6 May 2024

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.