Healthcare Provider Details

I. General information

NPI: 1811316706
Provider Name (Legal Business Name): COLLEEN MARIE ROBINSON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2014
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16180 SE SUNNYSIDE RD STE 102
HAPPY VALLEY OR
97015-6302
US

IV. Provider business mailing address

16180 SE SUNNYSIDE RD STE 102
HAPPY VALLEY OR
97015-6302
US

V. Phone/Fax

Practice location:
  • Phone: 503-582-4900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA215743
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number61677
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: