Healthcare Provider Details

I. General information

NPI: 1164486098
Provider Name (Legal Business Name): AGNIESZKA HELAK MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 02/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 SE 8TH AVE
HILLSBORO OR
97123
US

IV. Provider business mailing address

PO BOX 4008
PORTLAND OR
97208-4008
US

V. Phone/Fax

Practice location:
  • Phone: 503-681-1111
  • Fax:
Mailing address:
  • Phone: 503-372-2740
  • Fax: 503-372-2755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD24523
License Number StateOR

VIII. Authorized Official

Name: AGNIESZKA K HELAK
Title or Position: OWNER PRESIDENT
Credential: MD PC
Phone: 503-297-7223